Skip to main content
NCBI home page
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1997 Sep;56(9):521–525. doi: 10.1136/ard.56.9.521

Prevalence of Sjögren's syndrome in a closed rural community

U Dafni 1, A Tzioufas 1, P Staikos 1, F Skopouli 1, H Moutsopoulos 1
PMCID: PMC1752451  PMID: 9370875

Abstract

OBJECTIVE—To define the prevalence of Sjögren's syndrome (SS) through an epidemiological survey in a closed rural community. The classification of SS is based on the validated criteria reported by a multicentre study performed in Europe and supported by the Epidemiology Committee of the European Community (EEC-COMAC Epidemiology).
METHODS—The population under study consisted of 837 women aged 18 years or older, residing in the Astakos community of Aitoloakarnania, Greece. The study protocol was subdivided in two parts. In part I, an exhaustive epidemiological survey of these women was conducted in July and August of 1992. The validated questionnaire used in the survey assesses both ocular and oral involvement. In part II, 45 of the women reporting symptoms of both dry eye and dry mouth were approached for a full examination based on the validated set of classification criteria of SS. The full complement of the diagnostic tests was performed on 35 of these women. A subject is classified as a definite primary SS case if at least four of six items of the subject's test items are positive. If three of six items are positive the subject is classified as a probable primary SS case.
RESULTS—The classification criteria for definite primary SS were satisfied by five women. This number corresponds to an estimated prevalence of 0.60% (exact 95% CI 0.19%, 1.39%). Probable primary SS was diagnosed for 25 women (prevalence=2.99%).
CONCLUSION—Because of the loss of follow up (10 of 45) and the use of slightly stricter criteria for inclusion of possible SS cases in part II of the study, we consider our estimate of the prevalence of SS to be conservative. This study concurring with other recent reports, suggests that SS is more prevalent than previously thought.



Full Text

The Full Text of this article is available as a PDF (122.1 KB).

Figure 1  .

Figure 1  

Open in a new tab

Percentage of the 837 women answering positively to at least one question for either eye or mouth dryness, by age category.

Figure 2  .

Figure 2  

Open in a new tab

Percentage of women eligible for Part II and diagnosed with definite or probable primary SS, by age category.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arnett F. C., Edworthy S. M., Bloch D. A., McShane D. J., Fries J. F., Cooper N. S., Healey L. A., Kaplan S. R., Liang M. H., Luthra H. S. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988 Mar;31(3):315–324. doi: 10.1002/art.1780310302. [DOI] [PubMed] [Google Scholar]
  2. Bland J. H., Frymoyer J. W., Newberg A. H., Revers R., Norman R. J. Rheumatic syndromes in endocrine disease. Semin Arthritis Rheum. 1979 Aug;9(1):23–65. doi: 10.1016/0049-0172(79)90002-7. [DOI] [PubMed] [Google Scholar]
  3. Drosos A. A., Andonopoulos A. P., Costopoulos J. S., Papadimitriou C. S., Moutsopoulos H. M. Prevalence of primary Sjögren's syndrome in an elderly population. Br J Rheumatol. 1988 Apr;27(2):123–127. doi: 10.1093/rheumatology/27.2.123. [DOI] [PubMed] [Google Scholar]
  4. Jacobsson L. T., Axell T. E., Hansen B. U., Henricsson V. J., Larsson A., Lieberkind K., Lilja B., Manthorpe R. Dry eyes or mouth--an epidemiological study in Swedish adults, with special reference to primary Sjögren's syndrome. J Autoimmun. 1989 Aug;2(4):521–527. doi: 10.1016/0896-8411(89)90185-6. [DOI] [PubMed] [Google Scholar]
  5. Jacobsson L., Hansen B. U., Manthorpe R., Hardgrave K., Neas B., Harley J. B. Association of dry eyes and dry mouth with anti-Ro/SS-A and anti-La/SS-B autoantibodies in normal adults. Arthritis Rheum. 1992 Dec;35(12):1492–1501. doi: 10.1002/art.1780351213. [DOI] [PubMed] [Google Scholar]
  6. Pavlidis N. A., Karsh J., Moutsopoulos H. M. The clinical picture of primary Sjögren's syndrome: a retrospective study. J Rheumatol. 1982 Sep-Oct;9(5):685–690. [PubMed] [Google Scholar]
  7. Schur P. H., DeAngelis D., Jackson J. M. Immunological detection of nucleic acids and antibodies to nucleic acids and nuclear antigens by counterimmunoelectrophoresis. Clin Exp Immunol. 1974 May;17(1):209–218. [PMC free article] [PubMed] [Google Scholar]
  8. Scott J. Qualitative and quantitative observations on the histology of human labial salivary glands obtained post mortem. J Biol Buccale. 1980 Sep;8(3):187–200. [PubMed] [Google Scholar]
  9. Skopouli F. N., Siouna-Fatourou H. I., Ziciadis C., Moutsopoulos H. M. Evaluation of unstimulated whole saliva flow rate and stimulated parotid flow as confirmatory tests for xerostomia. Clin Exp Rheumatol. 1989 Mar-Apr;7(2):127–129. [PubMed] [Google Scholar]
  10. Strickland R. W., Tesar J. T., Berne B. H., Hobbs B. R., Lewis D. M., Welton R. C. The frequency of sicca syndrome in an elderly female population. J Rheumatol. 1987 Aug;14(4):766–771. [PubMed] [Google Scholar]
  11. Tan E. M., Cohen A. S., Fries J. F., Masi A. T., McShane D. J., Rothfield N. F., Schaller J. G., Talal N., Winchester R. J. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982 Nov;25(11):1271–1277. doi: 10.1002/art.1780251101. [DOI] [PubMed] [Google Scholar]
  12. Vitali C., Bombardieri S. Diagnostic criteria for Sjögren's syndrome: the state of the art. Clin Exp Rheumatol. 1990 Jul-Aug;8 (Suppl 5):13–16. [PubMed] [Google Scholar]
  13. Vitali C., Bombardieri S., Moutsopoulos H. M., Balestrieri G., Bencivelli W., Bernstein R. M., Bjerrum K. B., Braga S., Coll J., de Vita S. Preliminary criteria for the classification of Sjögren's syndrome. Results of a prospective concerted action supported by the European Community. Arthritis Rheum. 1993 Mar;36(3):340–347. doi: 10.1002/art.1780360309. [DOI] [PubMed] [Google Scholar]
  14. Vitali C., Bombardieri S., Moutsopoulos H. M., Coll J., Gerli R., Hatron P. Y., Kater L., Konttinen Y. T., Manthorpe R., Meyer O. Assessment of the European classification criteria for Sjögren's syndrome in a series of clinically defined cases: results of a prospective multicentre study. The European Study Group on Diagnostic Criteria for Sjögren's Syndrome. Ann Rheum Dis. 1996 Feb;55(2):116–121. doi: 10.1136/ard.55.2.116. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Vitali C., Moutsopoulos H. M., Bombardieri S. The European Community Study Group on diagnostic criteria for Sjögren's syndrome. Sensitivity and specificity of tests for ocular and oral involvement in Sjögren's syndrome. Ann Rheum Dis. 1994 Oct;53(10):637–647. doi: 10.1136/ard.53.10.637. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Whaley K., Williamson J., Wilson T., McGavin D. D., Hughes G. R., Hughes H., Schmulian L. R., MacSween R. N., Buchanan W. W. Sjögren's syndrome and autoimmunity in a geriatric population. Age Ageing. 1972 Nov;1(4):197–206. doi: 10.1093/ageing/1.4.197. [DOI] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES