Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (18 page)

BOOK: Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis
10.49Mb size Format: txt, pdf, ePub
   Laboratory Findings
   Positive ANA test, with high titers and a fine speckled staining pattern by IFA, is found in two thirds of patients.
   Anti-SSA/Ro and Anti-SSB/La antibodies are frequently detected in the serum of patients with SjS, and their presence supports the diagnosis. These antibodies are also detected in patients with SLE.
   RF is frequently positive because of the association of SjS with rheumatoid arthritis.
   CRP and ESR are typically elevated.
   Other laboratory tests are indicated to evaluate systemic and extraglandular involvement, and they include serum electrolytes, anticardiolipin antibodies, lupus anticoagulant, cryoglobulins, liver function tests, and urinalysis.
   Imaging studies and specific diagnostic tests of the glands can help with the diagnosis. Tests commonly used include Schirmer test to measure tear production, rose bengal test to assess the damage to epithelial cells in the cornea and conjunctivae, and tear breakup time test to measure overall lacrimal function.
Suggested Reading
Shiboski SC, Shiboski CH, Criswell L, et al. American College of Rheumatology classification criteria for Sjögren’s syndrome: a data-driven, expert consensus approach in the Sjögren’s International Collaborative Clinical Alliance cohort.
Arthritis Care Res.
2012;64(4):475–487.
SYSTEMIC LUPUS ERYTHEMATOSUS
   Definition
   SLE is a chronic autoimmune disease characterized by multisystem involvement and a variable clinical course. A prominent feature of SLE is the production of a number of antinuclear antibodies. The autoantibodies and immune complexes bind to various tissues, with resulting damage.
   According to the ACR classification criteria for SLE, a person is said to have SLE if any four or more of the following 11 criteria are present, serially or simultaneously, during any interval of observation:
   Malar rash
   Discoid rash

Other books

Most Eligible Baby Daddy by Chance Carter
Códex 10 by Eduard Pascual
Saving Maddie by Varian Johnson
If Looks Could Kill by Heather Graham
Destiny Unchained by Leia Shaw
Orange Blossom Brides by Tara Randel
The Invisible Enemy by Marthe Jocelyn
The Name of the World by Denis Johnson
The Death of Marco Styles by J.J. Campbell