Persistent serological activity in primary Sjögren's syndrome

Area of Science:

• Rheumatology
• Immunology
• Clinical Medicine

Background:

• Primary Sjögren's syndrome (pSS) is a chronic autoimmune disease characterized by lymphocytic infiltration of exocrine glands.
• Serological activity, reflecting ongoing immune system activation, is a key aspect of pSS.
• Understanding the persistence of serological activity and its clinical implications is crucial for patient management.

Purpose of the Study:

• To determine the prevalence of persistent serological activity in patients with primary Sjögren's syndrome.
• To investigate the association between persistent serological activity and clinical outcomes, including disease activity scores and specific organ involvement.

Main Methods:

• Retrospective review of clinical charts of 275 patients diagnosed with primary Sjögren's syndrome.
• Definition of persistent serological activity based on specific criteria for IgG, globulins, C3, and C4 levels over at least two consecutive visits within a year.
• Assessment of disease activity using the European League Against Rheumatism Sjögren's Syndrome Disease Activity Index (ClinESSDAI) and the Sjögren's Syndrome Diagnostic and Activity Index (SSDDI).

Main Results:

• Persistent serological activity was identified in 85 out of 159 (53.1%) patients with complete serological data.
• Patients with persistent serological activity showed a higher frequency of impaired salivary flow, anti-La/SSB antibodies, rheumatoid factor (RF), and higher ClinESSDAI scores.
• Logistic regression identified RF, renal, and hematological involvement as significantly associated with persistent serological activity.

Conclusions:

• Approximately half of the primary Sjögren's syndrome patients exhibit persistent serological activity, which remains relatively constant over time.
• Persistent serological activity is linked to increased disease activity, particularly affecting constitutional, glandular, cutaneous, renal, and hematological domains.
• Monitoring serological activity, especially in conjunction with RF, renal, and hematological markers, is important for managing patients with primary Sjögren's syndrome.