title: Prevalence of Sjögren's syndrome in ambulatory patients according to the American-European Consensus Group criteria.
abstract: OBJECTIVE
  To estimate the prevalence of Sjögren's syndrome (SS) in ambulatory patients attending a tertiary care centre, according to the American-European Consensus Group criteria, using a structured approach.
  
  
  METHODS
  Three hundred patients from rheumatology and internal medicine clinics were randomly chosen. During the screening phase, a face-to-face interview, a screening questionnaire, a Schirmer-I test and a wafer test were carried out in all patients. During the second phase, patients with positive screening had confirmatory tests including fluorescein staining test, non-stimulated whole salivary flow and autoantibody testing. Confirmatory tests were also done in 13 patients with negative screening. In the last phase, lip biopsy was proposed to those patients who met pre-established criteria.
  
  
  RESULTS
  Females constituted 79% of the study population. The mean age of the subjects was 42.8+/-15.7 yr. Two hundred and twenty patients (73%) had positive screening. Fifty-five (27%) out of 204 patients evaluated showed keratoconjunctivitis sicca and 28 (13%) out of 215 patients xerostomia. One hundred and sixty-eight patients met criteria for lip biopsy and it was performed in 80 subjects who accepted the procedure. Focal sialoadenitis was demonstrated in 39 patients (49%), but only 28 of them met criteria for SS. In total, 40 patients were classified as SS. The minimum prevalence of SS in the population studied was 13.3% (95% CI 9.5-17.1%). The structured approach used in this study allowed 24 (60%) undiagnosed cases of SS to be identified.
  
  
  CONCLUSIONS
  SS is common among ambulatory patients attending a tertiary care centre and in most of them it is undiagnosed.
authors.affiliation: Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, 14000 México, D.F. Mexico. jsanchez@quetzal.innsz.mx
authors.forename: J
authors.initials: J
authors.lastname: Sánchez-Guerrero
authors.forename: M R
authors.initials: MR
authors.lastname: Pérez-Dosal
authors.forename: F
authors.initials: F
authors.lastname: Cárdenas-Velázquez
authors.forename: A
authors.initials: A
authors.lastname: Pérez-Reguera
authors.forename: E
authors.initials: E
authors.lastname: Celis-Aguilar
authors.forename: A E
authors.initials: AE
authors.lastname: Soto-Rojas
authors.forename: C
authors.initials: C
authors.lastname: Avila-Casado
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001706:Biopsy / Q000379:methods; D005260:Female; D006801:Humans; D007638:Keratoconjunctivitis Sicca / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D008046:Lip / Q000473:pathology; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015995:Prevalence; D012859:Sjogren's Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D014987:Xerostomia / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology