title: Predicting Sjögren's syndrome in patients with recent-onset SLE.
abstract: OBJECTIVE
  To determine the prevalence of SS in a cohort of recent-onset SLE patients and evaluate the clinical and immunological variables that may identify SLE patients prone to develop SS.
  
  
  METHODS
  A total of 103 patients participating in a prospective cohort of recent-onset SLE were assessed for fulfilment of the American European Consensus Group criteria for SS using a three-phase approach: screening (European questionnaire, Schirmer-I test and wafer test), confirmation (fluorescein staining test, non-stimulated whole-salivary flow and anti-Ro/La antibodies) and lip biopsy. Anti-Ro/SSA and anti-La/SSB antibodies and RF were measured at entry into the cohort and at SS assessment.
  
  
  RESULTS
  Ninety-three females and 10 males were included. Mean age at lupus diagnosis was 25.9 ± 8.9 years, and lupus duration at SS assessment was 30.9 ± 9.1 years. SS was diagnosed in 19 (18.5%) patients, all female, and the patients were older at SLE diagnosis than patients without SS (30.8 ± 9.3 vs 24 ± 8.8 years, P = 0.004). Anti-Ro/SSA antibody was more common in SLE-SS patients (84% vs 55%, P = 0.02, LR + 1.53, 95% CI 1.14, 2.04). In the multivariate analysis, age ≥25 years and anti-Ro/SSA antibodies at SLE diagnosis were identified as predictors of SLE-SS, while the absence of anti-Ro/SSA, anti-La/SSB and RF seems to be protective (LR- 0.14, 95% CI 0.02, 0.95).
  
  
  CONCLUSIONS
  The overlap of SLE and SS occurs in almost one-fifth of SLE patients and presents early during its evolution. SLE onset at age ≥25 years plus the presence of anti-Ro/SSA antibody at diagnosis are useful predictors, while the absence of anti-Ro/SSA, anti-La/SSB and RF identifies patients at lowest risk.
authors.affiliation: Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Hernández-Molina
authors.forename: Tatiana
authors.initials: T
authors.lastname: Zamora-Legoff
authors.forename: Juanita
authors.initials: J
authors.lastname: Romero-Díaz
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Nuñez-Alvarez
authors.forename: Francisco
authors.initials: F
authors.lastname: Cárdenas-Velázquez
authors.forename: Carlos
authors.initials: C
authors.lastname: Hernández-Hernández
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Calderillo
authors.forename: Martha
authors.initials: M
authors.lastname: Marroquín
authors.forename: Claudia
authors.initials: C
authors.lastname: Recillas-Gispert
authors.forename: Carmen
authors.initials: C
authors.lastname: Ávila-Casado
authors.forename: Jorge
authors.initials: J
authors.lastname: Sánchez-Guerrero
mesh_terms: D000328:Adult; D017668:Age of Onset; D000974:Antibodies, Antinuclear / Q000276:immunology*; D015331:Cohort Studies; D016001:Confidence Intervals; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012859:Sjogren's Syndrome / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology; D055815:Young Adult
chemical_list: D000974:Antibodies, Antinuclear; C035356:SS-A antibodies
keywords: SLE; Sjögren’s syndrome; anti-Ro/SSA and anti-La/SSB antibodies