Discrepancy between subjective symptoms, objective measures and disease activity indexes: the lesson of primary Sjögren's syndrome

Mucosal dryness is a key clinical feature in primary Sjögren's syndrome (pSS) and its assessment relies on both objective measurement of residual secretion and subjective symptoms reported by patients. However, while the objective assessment and grading of glandular dysfunction can be easily pe...

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Bibliographic Details
Published in:Clinical and experimental rheumatology 2018-05, Vol.36 Suppl 112 (3), p.210-214
Main Authors: Alunno, Alessia, Bartoloni, Elena, Valentini, Valentina, La Paglia, Giuliana Maria Concetta, Valentini, Eleonora, Leone, Maria Comasia, Marcucci, Elisa, Cafaro, Giacomo, Bonifacio, Angelo Francesco, Luccioli, Filippo, Gerli, Roberto
Format: Article
Language:English
Subjects:
Decision Support Techniques
Humans
Lacrimal Apparatus - physiopathology
Lacrimal Apparatus - secretion
Patient Reported Outcome Measures
Predictive Value of Tests
Prognosis
Quality of Life
Reproducibility of Results
Salivary Glands - physiopathology
Salivation
Severity of Illness Index
Sjogren's Syndrome - diagnosis
Sjogren's Syndrome - immunology
Sjogren's Syndrome - physiopathology
Sjogren's Syndrome - psychology
Tears - secretion
Terminology as Topic
Xerophthalmia - diagnosis
Xerophthalmia - physiopathology
Xerophthalmia - psychology
Xerostomia - diagnosis
Xerostomia - physiopathology
Xerostomia - psychology
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Summary:Mucosal dryness is a key clinical feature in primary Sjögren's syndrome (pSS) and its assessment relies on both objective measurement of residual secretion and subjective symptoms reported by patients. However, while the objective assessment and grading of glandular dysfunction can be easily performed, the spectrum of clinical symptoms encompassed by the terms 'dry eye' and 'dry mouth' is wide and heterogeneous. Therefore, patient reported outcomes (PROs) for dryness in pSS poorly correlate with the amount of glandular secretion. In addition, subjective dryness is not correlated with the severity of systemic disease and severely affects the patient quality of life even in presence of active extraglandular manifestations. The purpose of this review article is to provide an overview of glandular dysfunction in pSS as well as the impact of discrepancy between objective assessment, subjective symptom and extraglandular disease activity on disease management.
ISSN:0392-856X