Pediatric Sjögren's Syndrome: Focus on Ocular Involvement and Diagnostic Challenges

Area of Science:

• Pediatric Rheumatology
• Ophthalmology
• Autoimmune Diseases

Background:

• Pediatric Sjögren's syndrome is a rare autoimmune disorder with diverse symptoms and few specific diagnostic criteria for children.
• Ocular manifestations are common early signs but often missed in pediatric patients.
• This study focuses on early immunological and clinical markers in pediatric Sjögren's syndrome.

Purpose of the Study:

• To evaluate pediatric Sjögren's syndrome by integrating systemic and ocular findings.
• To identify early immunological and clinical markers for diagnosis.
• To emphasize the role of ophthalmological assessments in early detection.

Main Methods:

• Retrospective analysis of six pediatric patients with Sjögren's syndrome.
• Ophthalmological assessments: tear break-up time (TBUT), Schirmer's test, slit-lamp examination.
• Evaluation of systemic features, serological markers (ANA, anti-SSA/Ro), and minor salivary gland biopsy.

Main Results:

• Consistent tear film instability (mean TBUT 7.4-7.7s) and inhomogeneous tear films observed in all patients.
• Blepharitis and Meibomian gland dysfunction noted in 66.7% of cases.
• Systemic symptoms (arthralgia, fatigue) and seropositivity (ANA, anti-SSA/Ro) were frequent; minor salivary gland biopsy confirmed lymphoepithelial sialadenitis.

Conclusions:

• Combining ophthalmological parameters (TBUT, slit-lamp) with laboratory and clinical markers aids early diagnosis of pediatric Sjögren's syndrome.
• Early diagnosis is crucial for timely intervention and preventing long-term complications.
• Integrated diagnostic approaches enhance accuracy in identifying this rare pediatric condition.