Comparison of 2002 AECG and 2016 ACR/EULAR classification criteria and added value of salivary gland ultrasonography in a patient cohort with suspected primary Sjögren’s syndrome
Abstract Background The objective was to evaluate concordance between 2002 American-European Consensus Group (AECG) and 2016 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria for primary Sjögren’s syndrome (pSS) and to assess how salivary gland...
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doaj-57173935b2d0493995fe1a2fb338a38e2020-11-25T01:33:59ZengBMCArthritis Research & Therapy1478-63622017-12-0119111010.1186/s13075-017-1475-xComparison of 2002 AECG and 2016 ACR/EULAR classification criteria and added value of salivary gland ultrasonography in a patient cohort with suspected primary Sjögren’s syndromeMaëlle Le Goff0Divi Cornec1Sandrine Jousse-Joulin2Dewi Guellec3Sebastian Costa4Thierry Marhadour5Rozenn Le Berre6Steeve Genestet7Béatrice Cochener8Sylvie Boisrame-Gastrin9Yves Renaudineau10Jacques-Olivier Pers11Alain Saraux12Valérie Devauchelle-Pensec13Centre National de Référence CERAINO, Service de Rhumatologie, Hôpital de la Cavale BlancheCentre National de Référence CERAINO, Service de Rhumatologie, Hôpital de la Cavale BlancheCentre National de Référence CERAINO, Service de Rhumatologie, Hôpital de la Cavale BlancheCentre National de Référence CERAINO, Service de Rhumatologie, Hôpital de la Cavale BlancheINSERM UMR1227, Lymphocytes B et Autoimmunité, Université de Bretagne OccidentaleCentre National de Référence CERAINO, Service de Rhumatologie, Hôpital de la Cavale BlancheMédecine Interne, CHRU BrestExplorations Fonctionnelles Neurologiques, CHRU BrestOphtalmologie, CHRU BrestOdontologie, CHRU BrestINSERM UMR1227, Lymphocytes B et Autoimmunité, Université de Bretagne OccidentaleINSERM UMR1227, Lymphocytes B et Autoimmunité, Université de Bretagne OccidentaleCentre National de Référence CERAINO, Service de Rhumatologie, Hôpital de la Cavale BlancheCentre National de Référence CERAINO, Service de Rhumatologie, Hôpital de la Cavale BlancheAbstract Background The objective was to evaluate concordance between 2002 American-European Consensus Group (AECG) and 2016 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria for primary Sjögren’s syndrome (pSS) and to assess how salivary gland ultrasonography (SGUS) might improve the classification of patients. Methods Patients with suspected pSS underwent a standardised evaluation, including SGUS, at inclusion into the single-centre Brittany DIApSS cohort. Agreement between the two criteria sets was assessed using Cohen’s κ coefficient. Characteristics of discordantly categorised patients were detailed. Results We prospectively included 290 patients between 2006 and 2016, among whom 125 (43%) met ACR/EULAR criteria and 114 (39%) also met AECG criteria; thus, 11 (4%) patients fulfilled only ACR/EULAR, no patients AECG only, and 165 (57%) patients neither criteria set. Concordance was excellent (κ = 0.92). Compared to patients fulfilling both criteria sets, the 11 patients fulfilling only ACR/EULAR criteria had similar age and symptom duration but lower frequencies of xerophthalmia and xerostomia (p < 0.01 for each) and salivary gland dysfunction (p < 0.01); most had systemic involvement (91%), including three (27%) with no sicca symptoms; 91% had abnormal salivary gland biopsy and 46% anti-Sjögren's-syndrome-related antigen A (anti-SSA); 64% were diagnosed with pSS by the physician. SGUS was abnormal in 12% of the 165 patients fulfilling no criteria set. Including SGUS among the ACR/EULAR criteria increased sensitivity from 87.4% to 91.1% when physician diagnosis was the reference standard. Conclusions Agreement between AECG and ACR/EULAR criteria sets is excellent. ACR/EULAR criteria are slightly more sensitive and classified some patients without sicca symptoms as having pSS. Including SGUS in the ACR/EULAR criteria may further improve their sensitivity.http://link.springer.com/article/10.1186/s13075-017-1475-xSjögren’s syndromePrimaryClassification criteriaDiagnosisUltrasonography |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Maëlle Le Goff Divi Cornec Sandrine Jousse-Joulin Dewi Guellec Sebastian Costa Thierry Marhadour Rozenn Le Berre Steeve Genestet Béatrice Cochener Sylvie Boisrame-Gastrin Yves Renaudineau Jacques-Olivier Pers Alain Saraux Valérie Devauchelle-Pensec |
spellingShingle |
Maëlle Le Goff Divi Cornec Sandrine Jousse-Joulin Dewi Guellec Sebastian Costa Thierry Marhadour Rozenn Le Berre Steeve Genestet Béatrice Cochener Sylvie Boisrame-Gastrin Yves Renaudineau Jacques-Olivier Pers Alain Saraux Valérie Devauchelle-Pensec Comparison of 2002 AECG and 2016 ACR/EULAR classification criteria and added value of salivary gland ultrasonography in a patient cohort with suspected primary Sjögren’s syndrome Arthritis Research & Therapy Sjögren’s syndrome Primary Classification criteria Diagnosis Ultrasonography |
author_facet |
Maëlle Le Goff Divi Cornec Sandrine Jousse-Joulin Dewi Guellec Sebastian Costa Thierry Marhadour Rozenn Le Berre Steeve Genestet Béatrice Cochener Sylvie Boisrame-Gastrin Yves Renaudineau Jacques-Olivier Pers Alain Saraux Valérie Devauchelle-Pensec |
author_sort |
Maëlle Le Goff |
title |
Comparison of 2002 AECG and 2016 ACR/EULAR classification criteria and added value of salivary gland ultrasonography in a patient cohort with suspected primary Sjögren’s syndrome |
title_short |
Comparison of 2002 AECG and 2016 ACR/EULAR classification criteria and added value of salivary gland ultrasonography in a patient cohort with suspected primary Sjögren’s syndrome |
title_full |
Comparison of 2002 AECG and 2016 ACR/EULAR classification criteria and added value of salivary gland ultrasonography in a patient cohort with suspected primary Sjögren’s syndrome |
title_fullStr |
Comparison of 2002 AECG and 2016 ACR/EULAR classification criteria and added value of salivary gland ultrasonography in a patient cohort with suspected primary Sjögren’s syndrome |
title_full_unstemmed |
Comparison of 2002 AECG and 2016 ACR/EULAR classification criteria and added value of salivary gland ultrasonography in a patient cohort with suspected primary Sjögren’s syndrome |
title_sort |
comparison of 2002 aecg and 2016 acr/eular classification criteria and added value of salivary gland ultrasonography in a patient cohort with suspected primary sjögren’s syndrome |
publisher |
BMC |
series |
Arthritis Research & Therapy |
issn |
1478-6362 |
publishDate |
2017-12-01 |
description |
Abstract Background The objective was to evaluate concordance between 2002 American-European Consensus Group (AECG) and 2016 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria for primary Sjögren’s syndrome (pSS) and to assess how salivary gland ultrasonography (SGUS) might improve the classification of patients. Methods Patients with suspected pSS underwent a standardised evaluation, including SGUS, at inclusion into the single-centre Brittany DIApSS cohort. Agreement between the two criteria sets was assessed using Cohen’s κ coefficient. Characteristics of discordantly categorised patients were detailed. Results We prospectively included 290 patients between 2006 and 2016, among whom 125 (43%) met ACR/EULAR criteria and 114 (39%) also met AECG criteria; thus, 11 (4%) patients fulfilled only ACR/EULAR, no patients AECG only, and 165 (57%) patients neither criteria set. Concordance was excellent (κ = 0.92). Compared to patients fulfilling both criteria sets, the 11 patients fulfilling only ACR/EULAR criteria had similar age and symptom duration but lower frequencies of xerophthalmia and xerostomia (p < 0.01 for each) and salivary gland dysfunction (p < 0.01); most had systemic involvement (91%), including three (27%) with no sicca symptoms; 91% had abnormal salivary gland biopsy and 46% anti-Sjögren's-syndrome-related antigen A (anti-SSA); 64% were diagnosed with pSS by the physician. SGUS was abnormal in 12% of the 165 patients fulfilling no criteria set. Including SGUS among the ACR/EULAR criteria increased sensitivity from 87.4% to 91.1% when physician diagnosis was the reference standard. Conclusions Agreement between AECG and ACR/EULAR criteria sets is excellent. ACR/EULAR criteria are slightly more sensitive and classified some patients without sicca symptoms as having pSS. Including SGUS in the ACR/EULAR criteria may further improve their sensitivity. |
topic |
Sjögren’s syndrome Primary Classification criteria Diagnosis Ultrasonography |
url |
http://link.springer.com/article/10.1186/s13075-017-1475-x |
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