Objectives
To estimate the incidence of physician-diagnosed primary Sjögren syndrome (SS) among
residents of Olmsted County, Minnesota, in the setting of usual medical care and to
determine how often objective criteria are available in the medical records of such
patients.
Patients and Methods
We reviewed all medical records of residents in Olmsted County with physician-diagnosed
SS from 1976 to 1992 to determine whether they had undergone objective tests for keratoconjunctivitis
sicca, salivary dysfunction, or serologic abnormality. Confounding illnesses were
excluded. To identify misclassified cases, all records from patients with xerostomia
or kerato-conjunctivitis sicca were also reviewed. The average annual SS incidence
rates were calculated by considering the entire population to be at risk.
Results
Of 75 patients with onset of SS during the study period, 53 had primary SS. All patients
were white, 51 (96.2%) were women, and the mean ± SD age was 59±15.8 years. The age-
and sex-adjusted annual incidence was 3.9 per 100,000 population (95% confidence interval,
2.8–4.9) for patients with primary SS. Eleven patients (20.8%) with physician-diagnosed
SS had no documentation of objective eye, mouth, or laboratory abnormalities. Objective
evaluations performed most frequently were laboratory and ocular tests and least often
were investigations of xerostomia.
Conclusions
The average annual incidence rate for physician-diagnosed primary SS in Olmsted County
is about 4 cases per 100,000 population. These data probably underestimate the true
incidence because they are based on usual medical care of patients with SS in a community
setting, rather than on a case-detection survey. In the future, a true incidence may
be possible with a higher index of suspicion, greater attention to objective tests,
and increased awareness of new classification criteria for SS. For epidemiological
studies based on existing data, application of current criteria may not be feasible,
and consensus on criteria for such studies would be useful.
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REFERENCES
- Sjögren's syndrome.Med Clin North Am. 1977; 61: 271-282
- The spectrum of benign to malignant lymphoproliferation in Sjögren's syndrome.Clin Exp Immunol. 1972; 10: 199-221
- Sjögren's syndrome: a clinical, pathological, and serological study of sixty-two cases.Medicine (Baltimore). 1965; 44: 187-231
- Prevalence of primary Sjögren's syndrome in an elderly population.Br J Rheumatol. 1988; 27: 123-127
- Sjögren's syndrome and autoimmunity in a geriatric population.Age Ageing. 1972; 1: 197-206
- The frequency of sicca syndrome in an elderly female population.J Rheumatol. 1987; 14: 766-771
- Zur Kenntnis der Keratoconjunctivitis sicca (Keratitis Filiformis bei Hypofunktion der Tränendrüsen).Acta Ophthalmol (Copenh). 1933; 11: 1-151
- Dry eyes or mouth—an epidemiological study in Swedish adults, with special reference to primary Sjögren's syndrome.J Autoimmun. 1989; 2: 521-527
- Prevalence of primary Sjögren's syndrome in China.J Rheumatol. 1995; 22: 659-661
- Prevalence of Sjögren's syndrome in Slovenia.Rheumatology (Oxford). 1999; 38: 164-170
- Sjögren's syndrome: a community-based study of prevalence and impact.Br J Rheumatol. 1998; 37: 1069-1076
- The Copenhagen criteria for Sjögren's syndrome.Scand J Rheumatol Suppl. 1986; 61: 19-21
- Preliminary diagnostic criteria for Sjögren's syndrome.Scand J Rheumatol Suppl. 1986; 61: 22-25
- Criteria for Sjögren's syndrome in Japan.Scand J Rheumatol Suppl. 1986; 61: 26-27
- Sjögren's syndrome: proposed criteria for classification.Arthritis Rheum. 1986; 29: 577-585
- Preliminary criteria for the classification of Sjögren's syndrome: results of a prospective concerted action supported by the European Community.Arthritis Rheum. 1993; 36: 340-347
- Criteria for diagnosis of Sjögren's syndrome.Rheum Dis Clin North Am. 1994; 20: 391-407
- History of the Rochester Epidemiology Project.Mayo Clin Proc. 1996; 71: 266-274
- Calculating incidence, prevalence and mortality rates for Olmsted County, Minnesota residents: an update. Technical Report Series, No. 49. Section of Biostatistics, Mayo Clinic, Rochester, MinnMarch 1992
- Epidemiologic features of diffuse connective tissue disorders in Rochester, Minn, 1951 through 1967, with special reference to systemic lupus erythematosus.Mayo Clin Proc. 1969; 44: 649-663
- Epidemiology of systemic lupus erythematosus and other connective tissue diseases in Rochester, Minnesota, 1950 through 1979.Mayo Clin Proc. 1985; 60: 105-113
- The incidence of systemic lupus erythematosus in Baltimore, Maryland, 1970–1977.Arthritis Rheum. 1985; 28: 80-86
- Estimating the incidence of systemic lupus erythematosus in a defined population using multiple sources of retrieval.Br J Rheumatol. 1990; 29: 185-188
- Systemic lupus erythematosus in Iceland 1975 through 1984: a nationwide epidemiological study in an unselected population.J Rheumatol. 1990; 17: 1162-1167
- Incidence of systemic lupus erythematosus: race and gender differences.Arthritis Rheum. 1995; 38: 1260-1270
- The prevalence and incidence of systemic lupus erythematosus in Birmingham, England: relationship to ethnicity and country of birth.Arthritis Rheum. 1995; 38: 551-558
- The epidemiology of rheumatoid arthritis in Rochester, Minnesota: a study of incidence, prevalence, and mortality.Am J Epidemiol. 1980; 111: 87-98
- Salivary gland dysfunction: causes, symptoms, treatment.J Am Dent Assoc. 1994; 125: 409-416
- Xerostomia and associated factors in a community-dwelling adult population.Community Dent Oral Epidemiol. 1996; 24: 312-316
- Xerostomia: prevalence and pharmacotherapy: with special reference to beta-adrenoceptor antagonists.Swed Dent J Suppl. 1996; 116: 1-70
- Medication and perception of dry mouth in a population of institutionalised elderly people.N Z Med J. 1993; 106: 219-221
- Subjective reports of oral dryness in an older adult population.Community Dent Oral Epidemiol. 1993; 21: 165-168
- Longitudinal study of stimulated whole saliva in an elderly population.Scand J Dent Res. 1992; 100: 340-345
- Incidence of dry mouth complaint in Cork Dental Hospital patient population.Stoma (Lisb). August-October 1990; 2 (58.): 55-56
- Lymphocytic sialadenitis in the major and minor glands: a correlation in postmortem subjects.J Clin Pathol. 1970; 23: 690-694
- Senile atrophy of the human lacrimal gland: the contribution of chronic inflammatory disease.Br J Ophthalmol. 1984; 68: 674-680
- Ageing and autoantibodies.Autoimmunity. 1988; 1: 141-149
- Association of dry eyes and dry mouth with anti-Ro/SS-A and anti-La/SS-B autoantibodies in normal adults.Arthritis Rheum. 1992; 35: 1492-1501
- Assessment of the European classification criteria for Sjögren's syndrome in a series of clinically defined cases: results of a prospective multicentre study.Ann Rheum Dis. 1996; 55: 116-121
- Ro(SS-A) and anti-Ro(SS-A): an update.Rev Rhum Engl Ed. 1998; 65: 45-57
- Prevalence of hepatitis B virus infection in the United States: the National Health and Nutrition Examination Surveys, 1976 through 1994.Am J Public Health. 1999; 89: 14-18
- Hepatitis C infection: a review.Lippincotts Prim Care Pract. 1999; 3: 345-353
Article info
Footnotes
Supported in part by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health research grant AR30582.
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Copyright
© 2001 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.