ADHERENCE TO »AMERICAN EUROPEAN CONSENSUS GROUP« CLASSIFICATION CRITERIA FOR SJÖGREN’S SYNDROME IN DIFFERENTIAL DIAGNOSIS OF XEROSTOMIA

Autori:

Slavica Pejda, Ivan Alajbeg, Iva Alajbeg

Sažetak

Svrhe rada su dobiti epidemiološke i etiološke podatke o problemu kserostomije u dijelu hrvatske populacije i utvrditi dosljednost pridržavanja klasifikacijskih kriterija American European Consensus Group (AECG) za Sjögrenov sindrom (SSj), s ciljem identificiranja moguće potrebe za poboljšanjem dijagnostičkog postupka u diferencijalnoj dijagnostici kserostomije. Retrospektivno istraživanje provedeno je u Zavodu za oralnu medicinu među bolesnicima primljenima zbog osjećaja suhih usta. Uključne kriterije zadovoljilo je 395 bolesnika. Napravljena je baza epidemioloških, kliničkih i sijalometrijskih podataka, nalaza seroloških, scintigrafskih, ultrazvučnih i patohistoloških pretraga žlijezda slinovnica te podataka o farmakoterapiji. Rabili su se deskriptivni statistički postupci. Salivarna hipofunkcija dokazana je u 74% bolesnika. Najčešći vjerojatni uzrok kserostomije bila je farmakoterapija. SSj je dokazan u 6,7% ispitanika sa kserostomijom, dok u 8% postoji visoka sumnja, ali biopsija labijalnih slinovnica nije učinjena, što upućuje na nepridržavanje kriterija AECG za dijagnostiku SSj-a. Nužno je provoditi kriterije AECG u obradi bolesnika sa suhim ustima i provesti edukaciju liječnika opće prakse, stomatologa i bolesnika o kserogenim nuspojavama farmakoterapije.

Summary

The aims were to obtain epidemiological and etiological data on xerostomia in cross section of Croatian population, and to evaluate adherence to »American European Consensus Group« (AECG) classification criteria for Sjögren’s syndrome (SSj), in order to identify possible need for improvements in differential diagnosis of xerostomia. A retrospective study among patients seen at the Department of oral medicine for complaints of dry mouth was performed. Three hundred and ninety-five patients met inclusion criteria. A data base was formed, comprising epidemiological, clinical and sialometric data, immunological, scintigraphic, ultrasonographic and histopathological findings of salivary glands, coupled with drug intake listings. Descriptive statistics were used for data analysis. Objective salivary hypofunction was found in 74% of our patients. The most common probable cause of xerostomia was side effect of pharmacotherapy. SSj was diagnosed in 6.7% of patients with xerostomia, whereas in another 8% of patients Sjögren’s syndrome was strongly suspected, but labial gland biopsy wasn’t performed, indicating a lack of adherence to AECG criteria for SSj diagnosis. Application of AECG criteria in differential diagnosis of patients with dry mouth is mandatory, as well as educating general practitioners, dentists and patients on xerogenic side effects of pharmacotherapy.

Volumen: 5-6, 2011

Liječ Vjesn 2011;133:180–186