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 |