Results of a Nationwide Multicenter Study in Childhood Sjögren Disease.
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Kılbaş Gülşah, Ayduran Semra, Şener Seher, Coşkuner Taner, Ulu Kadir, Kısaoğlu Hakan, Aslan Esma, Könte Elif Kılıç, Arslanaoğlu Ceyda, Aydın Tuncay, Oğuzkaya Yağmur Şadırvan, Çakmak Figen, Yıldırım Deniz Gezgin, Kaplan Melike Mehveş, Tığrak Saadet Nilay, Türkuçar Serkan, Sönmez Hafize Emine, Ekinci Miray Kışla, Öztürk Kübra, Demir Ferhat, Bağlan Esra, Bozkaya Burcu, Taşkın Sema Nur, Demir Selcan, Sağ Erdal, Batu Ezgi Deniz, Şahin Sezgin, Bakkaloğlu Sevcan A, Kilic Sara Sebnem, Kısaarslan Ayşenur Paç, Acar Banu Çelikel, Kalyoncu Mukaddes, Ayaz Nuray Aktay, Sözeri Betül, Ünsal Erbil, Kasapçopur Özgür, Özen Seza, Yüksel Selçuk
Аннотация
METHODS: This retrospective study included a total of 81 patients < 18 years of age from 21 pediatric rheumatology centers. Among these, 51 patients fulfilled the diagnosis of childhood SjD according to the 2016 American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) classification criteria. The remaining 30 patients-who did not fully meet these criteria but exhibited clinical and laboratory findings suggestive of SjD-were categorized as at risk for childhood SjD to highlight diagnostic challenges and the spectrum of early presentations, based on comprehensive clinical evaluation by experienced pediatric rheumatologists.
RESULTS: The cohort consisted of 81 patients (85.2% female, 14.8% male) with a median age at symptom onset of 11.4 years and a median follow-up of 24 months. Common clinical manifestations included dry mouth, dry eyes, arthralgia, fatigue, and parotitis. Fifty-one of the 81 patients met the 2016 ACR/EULAR classification criteria, whereas the remaining 30 were classified as an at-risk group. The most common clinical findings in the at-risk group were xerostomia (90%), arthralgia (56.7%), fatigue (50%), and dry eyes (43.3%). Dry mouth and peripheral nervous system involvements were found to be higher in patients categorized as at risk (P = 0.03 and P = 0.02, respectively).
CONCLUSION: The current classification criteria for childhood SjD appear to be inadequate, highlighting the need for pediatric-specific criteria that more accurately reflect the distinct clinical patterns observed in children.