Evaluation of clinical, scintigraphic, and histopathological features in patients with patients with a presumptive diagnosis of Sjögren’s syndrome

Abstract

Introduction

Sicca syndrome is characterized by the presence of dry eye (xerophthalmia - keratoconjunctivitis sicca), dry mouth (xerostomia), and dry skin (xeroderma), this triad may be related to Sjögren’s syndrome.

Objective

To associate the clinical, scintigraphic, and histopathological characteristics of patients with xerostomia and diagnosis of SS and presumptive diagnosis of Sjögren's syndrome in Medellín-Colombia, 2018–2020.

Materials and methods

The study was a quantitative approach, with cross-sectional analysis. The participants were grouped into two groups: diagnosis of Sicca syndrome and presumptive diagnosis of Sjögren's syndrome, and a survey of sociodemographic data was applied. For each group, salivary flow measurements, Schirmer’s test, salivary gland scintigraphic study, and histological evaluation were performed. Statistical analysis was performed using measures of central tendency (median) and dispersion (interquartile range), Fisher’s exact test, and the Wilcoxon test (U Man-Whitney).

Results

The total sample studied consisted of 24 women, whose most frequent systemic clinical symptom was joint pain in Sicca syndrome (90%), and in the group of presumptive diagnosis of Sjögren’s syndrome (92.9%), while the most frequent sign was tongue depapillation in Sicca syndrome (100%) and in the group of presumptive diagnosis of Sjögren’s syndrome (92.9%). Functional tests, unstimulated salivary flow rate, and salivary gland scintigraphy showed greater involvement in the group of presumptive diagnosis of Sjögren’s syndrome. Histopathological analysis showed atrophic changes, fibrosis, and fatty changes in both categories.

Conclusion

The findings suggest that patients with a presumptive diagnosis of Sicca syndrome may be in an early phase of Sjögren's syndrome progression, so this study aims to establish an association of signs, symptoms, and diagnostic aids to define an accurate diagnosis and therapy.