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Table 1 Diagnostic criteria for Sjögren’s syndrome (American-European Consensus for Sjögren’s syndrome [8])

From: Overlap syndrome with Sjögren’s syndrome and systemic sclerosis in a steel rolling mill worker: a case report

Criteriaa

I. Ocular symptoms (at least one)

 1. Dry eyes for at least 3 months

 2. A foreign body sensation in the eyes

 3. Use of artificial tears three or more times per day

II. Oral symptoms (at least one)

 1. Dry mouth for at least 3 months

 2. Recurrent or persistently swollen salivary glands

 3. Need for liquids to swallow dry foods

III. Ocular signs (at least one)

 1. Abnormal Schimer’s test (5 mm or less in 5 min)

 2. Positive vital dye staining (van Bijsterveld score 4 or higher)

IV. Histopathology

 1. Lip biopsy showing focal lymphocytic sialoadenitis (focus score ≥1 per 4 mm2)

V. Oral signs (at least one)

 1. Unstimulated whole salivary flow (1.5 ml or less in 15 min)

 2. Abnormal parotid sialography

 3. Abnormal salivary scintigraphy

VI. Autoantibodies (at least one)

 1. Anti-SSA (Ro) or anti-SSB (La) or both

VII. Exclusion criteria

 1. Past head and neck radiation treatment

 2. Hepatitis C infection

 3. Acquired immunodeficiency syndrome

 4. Pre-existing lymphoma

 5. Sarcoidosis

 6. Graft versus host disease

 7. Current use of anticholinergic drugs

  1. aFor primary Sjögren’s syndrome, (i) any 4 of the 6 criteria, must include either item IV (histopathology) or VI (autoantibodies) or (ii) any 3 of the 4 objective criteria (III, IV, V, VI); for secondary Sjögren’s syndrome, in patients with another well-defined major connective tissue disease, the presence of one symptom (I or II) plus 2 of the 3 objective criteria (III, IV and V)