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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Article info
Footnotes
Supported in part by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health research grant AR30582.
Identification
Copyright
© 2001 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
