[The diagnosis of Gougerot-Sjorgen syndrome in rheumatology. I. Evaul ation of the principal complementary examinations]

Abstract

The examination of a patient with Sjögren's syndrome includes evaluation of the eye, the buccal cavity, and a search for certain factors in the blood. Schirmer's blotting-paper test is a good test but is not specific. In addition, a decreased amount of tearing is difficult to interpret after the age of 45. Slit-lamp examination (rose bengal and fluorescein) yields lesions which confirm keratoconjunctivitis due to decreased tearing. The buccal component is difficult to evaluate. A biopsy of the buccal mucosa gives the best results with minimum risk and expense. Nucleotide scanning is sensitive, but less specific. Salivary flow decreases with age. After 60 years of age this decrease can not be interpreted. The chemical composition of tears or of saliva is promising, but it is not yet a part of the usual diagnostic work-up. Of the available laboratory tests, anti-SS-A antibodies and/ or anti-SS-B antibodies are of value, but they are not found consistently.