A new approach for diagnosis of the primary sjogren’ syndrome

Menicagli, R., and Duca, M.

Introduction Aims: Primary Sjögren's syndrome (pSS), is considered a rare disease, but also present in countries with high prevalence not exactly high economic development and technology. The correct diagnosis is made with the criteria established by the American-European Consensus Group (AECG): presence of both ocular and salivary sign, the appearance of specific auto antibodies in serum and / or positive histopathological test of the salivary glands. This diagnosis is most expensive, because it requires the collaboration with several specialists and a laboratory service for histological exams. Our aim is to propose a diagnostic method performed by “physician of general medicine”after a short training perform the Shimmer’s test, the salivary flow test, and the detection of antibodies, anti-Ro (SSA), anti-La (SSA) with a quick test in the saliva of the patients.
Materials and Methods: Twenty ,of about 8,000 patients, visiting five primary care clinics showed suspected history of (pSS), with dry mouth and congiuntival drynessl .On these, was made of salivary flow testing, the detection of auto antibodies ANA / ENA in saliva with Immuno Blot assay, an eye medical history and conduct of the Schirmer’ s test. The diagnostic criterion is indicated by (AECG). For the positive patients were then carried all the classics specialist examinations as provided for by the protocol to confirm the diagnosis
Results And Discussion: Seven patients were positive for the Schirmer’s test and salivary flow were present in the saliva of four anti-Ro (SSA), and according to the protocol (AECG), suffering (pSS). One patient tested positive for suspected Histones SLE, while for the other two, the immune blot is very slight bands SMD1 of difficult valutation. I by subsequent checks have confirmed the presence of four p SS, a case of SLE and two secondary SS for LES.
Conclusions: This research proposes a new reliable diagnostic procedure, for the diagnosis of pSS accordance with the criteria (AECG), and may be carried out as basic screening, at low cost, even in simple medical structures by primary care physicians. There may also be used with sufficient diagnostic reliability for the secondary Sjogren's syndrome and other autoimmune diseases, since in most cases the concentration of antibodies in saliva is very low.

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           Prof. Dr. Bilal BİLGİN

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