Differential diagnosis of Sjogren’s disease


DOI: https://dx.doi.org/10.18565/therapy.2022.2.96-102

Torgashina A.V.

V.A. Nasonova Research Institute of Rheumatology, Moscow
Abstract. The article describes differential diagnosis of Sjogren’s syndrome, in particular, various causes of the most common clinical manifestations such as sicca syndrome and sialomegaly are discussed. The possible causes of both underdiagnosis and overdiagnosis of Sjogren’s syndrome are analyzed.
Keywords: MALT lymphoma, sialomegaly, sicca syndrome, Sjögren’s disease
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Literature


  1. Сафонова Т.Н., В.И. Васильев, Лихванцева В.Г. Синдром Шегрена: руководство для врачей. Под ред. В.Г. Лихванцевой. М.: Издательство Московского университета. 2013; 600 с. [Safonova T.N., V.I. Vasiliev, Likhvantseva V.G. Sjogren’s syndrome: a guide for physicians. Ed. by Likhvantseva V.G. Moscow; Moscow University Press. 2013; 600 pp. (In Russ.)]. ISBN: 978-5-19-010836-1.

  2. Qin, B., Wang, J., Yang, Z. et al. Epidemiology of primary Sjogren’s syndrome: A systematic review and meta-analysis. Ann Rheum Dis. 2014; 74(11): 1983–89. https://dx.doi.org/10.1136/annrheumdis-2014-205375.

  3. Shiboski C.H., Shiboski S.C., Seror R. et al. 2016 American College of Rheumatology/European League Against Rheumatism classification criteria for primary Sjogren’s syndrome: A consensus and data-driven methodology involving three international patient cohorts. Arthritis Rheumatol. 2017; 69(1): 35–45. https://dx.doi.org/10.1002/art.39859.

  4. Helmick C.G., Felson D.T., Lawrence R.C. et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part I. Arthritis Rheum. 2008; 58(1): 15–25. https://dx.doi.org/10.1002/art.23177.

  5. Hopcraft M.S., Tan C. Xerostomia: An update for clinicians. Aust Dent J. 2010; 55(3): 238–44; quiz 353. https://dx.doi.org/10.1111/j.1834-7819.2010.01229.x.

  6. Cartee D.L., Maker S., Dalonges D., Manski M.C. Sjogren’s syndrome: Oral manifestations and treatment, a dental perspective. J Dent Hyg. 2015; 89(6): 365–71.

  7. Kaplan I., Zuk-Paz L., Wolff A. Association between salivary flow rates, oral symptoms, and oral mucosal status. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 106(2): 235–41. https://dx.doi.org/10.1016/j.tripleo.2007.11.029.

  8. Российские клинические рекомендации. Ревматология. Под ред. Е.Л. Насонова. М.: ГЭОТАР-Медиа. 2017; 464 с. [Russian clinical guidelines. Rheumatology. Moscow: GEOTAR-Media. 2017; 464 pp. (In Russ.)]. ISBN: 978-5-9704-4261-6.

  9. Wick J.Y. Xerostomia: Causes and treatment. Consult Pharm. 2007; 22(12): 985–92. https://dx.doi.org/10.4140/tcp.n.2007.985.

  10. Beckman K.A., Luchs J., Milner M.S. Making the diagnosis of Sjogren’s syndrome in patients with dry eye. Clin Ophthalmol. 2015; 10: 43–53. https://dx.doi.org/10.2147/OPTH.

  11. Akpek E.K., Bunya V.Y., Saldanha I.J. Sjogren’s syndrome: More than just dry eye. Cornea. 2019; 38(5): 658–61. https://dx.doi.org/10.1097/ICO.0000000000001865.

  12. Murtagh P., Comer R., Fahy G. Corneal perforation in undiagnosed Sjogren’s syndrome following topical NSAID and steroid drops post routine cataract extraction. BMJ Case Rep. 2018; 2018: bcr2018225428. https://dx.doi.org/10.1136/bcr-2018-225428.

  13. Liu K.C., Huynh K., Grubbs J. Jr., Davis R.M. Autoimmunity in the pathogenesis and treatment of keratoconjunctivitis sicca. Curr Allergy Asthma Rep. 2014; 14(1): 403. https://dx.doi.org/10.1007/s11882-013-0403-7.

  14. Zeev M.S., Miller D.D., Latkany R. Diagnosis of dry eye disease and emerging technologies. Clin Ophthalmol. 2014; 8: 581–90. https://dx.doi.org/10.2147/OPTH.S45444.

  15. Liao R., Yang H.T., Li H. Recent advances of salivary gland biopsy in Sjogren’s syndrome. Front Med (Lausanne). 2022; 8: 792593. https://dx.doi.org/10.3389/fmed.2021.792593.

  16. Васильев В.И., Гайдук И.В., Пальшина С.Г. с соавт. Первичные онкогематологические заболевания, дебютирующие с поражения больших слюнных желез в ревматологической практике. Современная ревматология. 2019; 1: 44–51. [Vasilyev V.I., Gaiduk I.V., Palshina S.G. et al. Primary hematologic malignancies with the onset of involvement of the major salivary glands in rheumatologic practice. Sovremennaya revmatologiya = Modern Rheumatology Journal. 2019; 1: 44–51 (In Russ.)]. https://dx.doi.org/10.14412/1996-7012-2019-1-44-51.

  17. Cheah C.Y. Marginal zone lymphoma: present status and future perspectives. Haematologica. 2022; 107(1): 35–43. https://dx.doi.org/10.3324/haematol.2021.278755.

  18. Akiyama M., Takanashi S., Takeuchi T. Salivary gland involvement in ANCA-associated vasculitis. Autoimmun Rev. 2021; 20(11): 102940. https://dx.doi.org/10.1016/j.autrev.2021.102940.

  19. Сокол Е.В. IgG4-связанное заболевание: что мы знаем 20 лет спустя. Терапевтический архив. 2020; 5: 104–109. [Sokol E.V. IgG4-related disease: what do we know after 20 years. Terapevticheskiy arkhiv = Therapeutic archive. 2020; 5: 104–109 (In Russ.)]. https://dx.doi.org/10.26442/00403660.2020.05.000632.

  20. Puxeddu I., Capecchi R., Carta F. et al. Salivary gland pathology in IgG4-related disease: A comprehensive review. J Immunol Res. 2018; 2018: 6936727. https://dx.doi.org/10.1155/2018/6936727.

  21. Сокол Е.В. Новые классификационные критерии IgG4-связанного заболевания Американской коллегии ревматологов (ACR)/Европейской антиревматической лиги (EULAR), 2019. Научно-практическая ревматология. 2020; 4: 368–375. [Sokol E.V. The new 2019 American college of rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria for IgG4-related disease. Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practice. 2020; 4: 368–375 (In Russ.)]. https://dx.doi.org/10.47360/1995-4484-2020-368-375.

  22. Chen S., Paul B.C., Myssiorek D. An algorithm approach to diagnosing bilateral parotid enlargement. Otolaryngol Head Neck Surg 2013; 148(5): 732–39. https://dx.doi.org/10.1177/0194599813476669.

  23. Scully C., Bagan J.V., Eveson J.W. et al. Sialosis: 35 cases of persistent parotid swelling from two countries. Br J Oral Maxillofac Surg. 2008; 46(6): 468–72. https://dx.doi.org/10.1016/j.bjoms.2008.01.014.

  24. Ogle O.E. Salivary gland diseases. Dent Clin North Am. 2020; 64(1): 87–104. https://dx.doi.org/10.1016/j.cden.2019.08.007.

  25. Li Х., Zhao Y-N., Zhang L-Q. Differences between radioactive iodine-induced sialadenitis and chronic obstructive parotitis. Int J Oral Maxillofac Surg. 2021; S0901-5027(21)00391-X. https://dx.doi.org/10.1016/j.ijom.2021.11.003.

  26. Meer S. Human immunodeficiency virus and salivary gland pathology: an update. Oral Surg Oral Med Oral Pathol Oral Radiol. 2019; 128(1): 52–59. https://dx.doi.org/10.1016/j.oooo.2019.01.001.

  27. Ghrenassia E., Martis N., Boyer J. et al. The diffuse infiltrative lymphocytosis syndrome (DILS). J Autoimmun. 2015; 59: 19–25. https://dx.doi.org/10.1016/j.jaut.2015.01.010.

  28. Kim Y.H., Jeong W.J., Jung K.Y. et al. Diagnosis of major salivary gland tuberculosis: experience of eight cases and review of the literature. Acta Otolaryngol. 2005; 125(12): 1318–22. https://dx.doi.org/10.1080/00016480510012246.

  29. Seve P., Pacheco Y., Durupt F. et al. Sarcoidosis: A clinical overview from symptoms to diagnosis. Cells. 2021; 10(4): 766. https://dx.doi.org/10.3390/cells10040766.

  30. Saarilahti K., Kouri M., Collan J. et al. Intensity modulated radio-therapy for head and neck cancer: Evidence for preserved salivary gland function. Radiother Oncol. 2005; 74(3): 251–58. https://dx.doi.org/10.1016/j.radonc.2004.11.004.

  31. Young A., Okuyemi O.T. Benign salivary gland tumors. 2021. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. PMID: 33231965.

  32. Moreddu E., Baumstarck-Barrau K., Gabriel S. et al. Incidence of salivary side effects after radioiodine treatment using a new specifically-designed questionnaire. Br J Oral Maxillofac Surg. 2017; 55(6): 609–12. https://dx.doi.org/10.1016/j.bjoms.2017.03.019.

  33. Agaimy A. Papillary neoplasms of the salivary duct system: A review. Surg Pathol Clin. 2021; 14(1): 53–65. https://dx.doi.org/10.1016/j.path.2020.09.007.

  34. Alnoor F., Gandhi J.S., Stein M.K. et al. Follicular lymphoma diagnosed in warthin tumor: a case report and review of the literature. Head Neck Pathol. 2020; 14(2): 386–91. https://dx.doi.org/10.1007/s12105-019-01045-x.


About the Autors

Anna V. Torgashina, PhD, head of the Laboratory of rare rheumatic diseases and Sjogren’s disease, V.A. Nasonova Research Institute of Rheumatology. Address: 115522, Moscow, 34А Kashirskoe Highway. E-mail: anna.torgashina@gmail.com. ORCID: https://orcid.org/0000-0001-8099-2107

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