Incidence of physician-diagnosed primary Sjögren syndrome in residents of Olmsted County, Minnesota

Stanley R. Pillemer, Eric Lawrence Matteson, Lennart T H Jacobsson, Peter B. Martens, L. Joseph Melton W Michael O'Fallon, Philip C. Fox

Research output: Contribution to journalArticle

138 Citations (Scopus)

Abstract

Objectives: To estimate the incidence of physician-diagnosed primary Sjögren syndrome (SS) among residents of Olmsted County, Minnesota, in the setting of usual medical care and to determine how often objective criteria are available in the medical records of such patients. Patients and Methods: We reviewed all medical records of residents in Olmsted County with physician-diagnosed SS from 1976 to 1992 to determine whether they had undergone objective tests for keratoconjunctivitis sicca, salivary dysfunction, or serologic abnormality. Confounding illnesses were excluded. To identify misclassified cases, all records from patients with xerostomia or keratoconjunctivitis sicca were also reviewed. The average annual SS incidence rates were calculated by considering the entire population to be at risk. Results: Of 75 patients with onset of SS during the study period, 53 had primary SS. All patients were white, 51 (96.2%) were women, and the mean ± SD age was 59±15.8 years. The age- and sex-adjusted annual incidence was 3.9 per 100,000 population (95% confidence interval, 2.8-4.9) for patients with primary SS. Eleven patients (20.8%) with physician-diagnosed SS had no documentation of objective eye, mouth, or laboratory abnormalities. Objective evaluations performed most frequently were laboratory and ocular tests and least often were investigations of xerostomia. Conclusions: The average annual incidence rate for physician-diagnosed primary SS in Olmsted County is about 4 cases per 100,000 population. These data probably underestimate the true incidence because they are based on usual medical care of patients with SS in a community setting, rather than on a case-detection survey. In the future, a true incidence may be possible with a higher index of suspicion, greater attention to objective tests, and increased awareness of new classification criteria for SS. For epidemiological studies based on existing data, application of current criteria may not be feasible, and consensus on criteria for such studies would be useful.

Original languageEnglish (US)
Pages (from-to)593-599
Number of pages7
JournalMayo Clinic Proceedings
Volume76
Issue number6
StatePublished - 2001

Fingerprint

Physicians
Incidence
Keratoconjunctivitis Sicca
Xerostomia
Medical Records
Population
Documentation
Mouth
Epidemiologic Studies
Patient Care
Confidence Intervals

Keywords

  • ANA = antinuclear antibody
  • CI = confidence interval
  • HIV = human immunodeficiency virus
  • KCS = keratoconjunctivitis sicca
  • RA = rheumatoid arthritis
  • SLE = systemic lupus erythematosus
  • SS = Sjögren syndrome
  • XS = xerostomia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Pillemer, S. R., Matteson, E. L., Jacobsson, L. T. H., Martens, P. B., Joseph Melton W Michael O'Fallon, L., & Fox, P. C. (2001). Incidence of physician-diagnosed primary Sjögren syndrome in residents of Olmsted County, Minnesota. Mayo Clinic Proceedings, 76(6), 593-599.

Incidence of physician-diagnosed primary Sjögren syndrome in residents of Olmsted County, Minnesota. / Pillemer, Stanley R.; Matteson, Eric Lawrence; Jacobsson, Lennart T H; Martens, Peter B.; Joseph Melton W Michael O'Fallon, L.; Fox, Philip C.

In: Mayo Clinic Proceedings, Vol. 76, No. 6, 2001, p. 593-599.

Research output: Contribution to journalArticle

Pillemer, SR, Matteson, EL, Jacobsson, LTH, Martens, PB, Joseph Melton W Michael O'Fallon, L & Fox, PC 2001, 'Incidence of physician-diagnosed primary Sjögren syndrome in residents of Olmsted County, Minnesota', Mayo Clinic Proceedings, vol. 76, no. 6, pp. 593-599.
Pillemer SR, Matteson EL, Jacobsson LTH, Martens PB, Joseph Melton W Michael O'Fallon L, Fox PC. Incidence of physician-diagnosed primary Sjögren syndrome in residents of Olmsted County, Minnesota. Mayo Clinic Proceedings. 2001;76(6):593-599.
Pillemer, Stanley R. ; Matteson, Eric Lawrence ; Jacobsson, Lennart T H ; Martens, Peter B. ; Joseph Melton W Michael O'Fallon, L. ; Fox, Philip C. / Incidence of physician-diagnosed primary Sjögren syndrome in residents of Olmsted County, Minnesota. In: Mayo Clinic Proceedings. 2001 ; Vol. 76, No. 6. pp. 593-599.
@article{42d44516e85e499da39199a464130d83,
title = "Incidence of physician-diagnosed primary Sj{\"o}gren syndrome in residents of Olmsted County, Minnesota",
abstract = "Objectives: To estimate the incidence of physician-diagnosed primary Sj{\"o}gren syndrome (SS) among residents of Olmsted County, Minnesota, in the setting of usual medical care and to determine how often objective criteria are available in the medical records of such patients. Patients and Methods: We reviewed all medical records of residents in Olmsted County with physician-diagnosed SS from 1976 to 1992 to determine whether they had undergone objective tests for keratoconjunctivitis sicca, salivary dysfunction, or serologic abnormality. Confounding illnesses were excluded. To identify misclassified cases, all records from patients with xerostomia or keratoconjunctivitis sicca were also reviewed. The average annual SS incidence rates were calculated by considering the entire population to be at risk. Results: Of 75 patients with onset of SS during the study period, 53 had primary SS. All patients were white, 51 (96.2{\%}) were women, and the mean ± SD age was 59±15.8 years. The age- and sex-adjusted annual incidence was 3.9 per 100,000 population (95{\%} confidence interval, 2.8-4.9) for patients with primary SS. Eleven patients (20.8{\%}) with physician-diagnosed SS had no documentation of objective eye, mouth, or laboratory abnormalities. Objective evaluations performed most frequently were laboratory and ocular tests and least often were investigations of xerostomia. Conclusions: The average annual incidence rate for physician-diagnosed primary SS in Olmsted County is about 4 cases per 100,000 population. These data probably underestimate the true incidence because they are based on usual medical care of patients with SS in a community setting, rather than on a case-detection survey. In the future, a true incidence may be possible with a higher index of suspicion, greater attention to objective tests, and increased awareness of new classification criteria for SS. For epidemiological studies based on existing data, application of current criteria may not be feasible, and consensus on criteria for such studies would be useful.",
keywords = "ANA = antinuclear antibody, CI = confidence interval, HIV = human immunodeficiency virus, KCS = keratoconjunctivitis sicca, RA = rheumatoid arthritis, SLE = systemic lupus erythematosus, SS = Sj{\"o}gren syndrome, XS = xerostomia",
author = "Pillemer, {Stanley R.} and Matteson, {Eric Lawrence} and Jacobsson, {Lennart T H} and Martens, {Peter B.} and {Joseph Melton W Michael O'Fallon}, L. and Fox, {Philip C.}",
year = "2001",
language = "English (US)",
volume = "76",
pages = "593--599",
journal = "Mayo Clinic Proceedings",
issn = "0025-6196",
publisher = "Elsevier Science",
number = "6",

}

TY - JOUR

T1 - Incidence of physician-diagnosed primary Sjögren syndrome in residents of Olmsted County, Minnesota

AU - Pillemer, Stanley R.

AU - Matteson, Eric Lawrence

AU - Jacobsson, Lennart T H

AU - Martens, Peter B.

AU - Joseph Melton W Michael O'Fallon, L.

AU - Fox, Philip C.

PY - 2001

Y1 - 2001

N2 - Objectives: To estimate the incidence of physician-diagnosed primary Sjögren syndrome (SS) among residents of Olmsted County, Minnesota, in the setting of usual medical care and to determine how often objective criteria are available in the medical records of such patients. Patients and Methods: We reviewed all medical records of residents in Olmsted County with physician-diagnosed SS from 1976 to 1992 to determine whether they had undergone objective tests for keratoconjunctivitis sicca, salivary dysfunction, or serologic abnormality. Confounding illnesses were excluded. To identify misclassified cases, all records from patients with xerostomia or keratoconjunctivitis sicca were also reviewed. The average annual SS incidence rates were calculated by considering the entire population to be at risk. Results: Of 75 patients with onset of SS during the study period, 53 had primary SS. All patients were white, 51 (96.2%) were women, and the mean ± SD age was 59±15.8 years. The age- and sex-adjusted annual incidence was 3.9 per 100,000 population (95% confidence interval, 2.8-4.9) for patients with primary SS. Eleven patients (20.8%) with physician-diagnosed SS had no documentation of objective eye, mouth, or laboratory abnormalities. Objective evaluations performed most frequently were laboratory and ocular tests and least often were investigations of xerostomia. Conclusions: The average annual incidence rate for physician-diagnosed primary SS in Olmsted County is about 4 cases per 100,000 population. These data probably underestimate the true incidence because they are based on usual medical care of patients with SS in a community setting, rather than on a case-detection survey. In the future, a true incidence may be possible with a higher index of suspicion, greater attention to objective tests, and increased awareness of new classification criteria for SS. For epidemiological studies based on existing data, application of current criteria may not be feasible, and consensus on criteria for such studies would be useful.

AB - Objectives: To estimate the incidence of physician-diagnosed primary Sjögren syndrome (SS) among residents of Olmsted County, Minnesota, in the setting of usual medical care and to determine how often objective criteria are available in the medical records of such patients. Patients and Methods: We reviewed all medical records of residents in Olmsted County with physician-diagnosed SS from 1976 to 1992 to determine whether they had undergone objective tests for keratoconjunctivitis sicca, salivary dysfunction, or serologic abnormality. Confounding illnesses were excluded. To identify misclassified cases, all records from patients with xerostomia or keratoconjunctivitis sicca were also reviewed. The average annual SS incidence rates were calculated by considering the entire population to be at risk. Results: Of 75 patients with onset of SS during the study period, 53 had primary SS. All patients were white, 51 (96.2%) were women, and the mean ± SD age was 59±15.8 years. The age- and sex-adjusted annual incidence was 3.9 per 100,000 population (95% confidence interval, 2.8-4.9) for patients with primary SS. Eleven patients (20.8%) with physician-diagnosed SS had no documentation of objective eye, mouth, or laboratory abnormalities. Objective evaluations performed most frequently were laboratory and ocular tests and least often were investigations of xerostomia. Conclusions: The average annual incidence rate for physician-diagnosed primary SS in Olmsted County is about 4 cases per 100,000 population. These data probably underestimate the true incidence because they are based on usual medical care of patients with SS in a community setting, rather than on a case-detection survey. In the future, a true incidence may be possible with a higher index of suspicion, greater attention to objective tests, and increased awareness of new classification criteria for SS. For epidemiological studies based on existing data, application of current criteria may not be feasible, and consensus on criteria for such studies would be useful.

KW - ANA = antinuclear antibody

KW - CI = confidence interval

KW - HIV = human immunodeficiency virus

KW - KCS = keratoconjunctivitis sicca

KW - RA = rheumatoid arthritis

KW - SLE = systemic lupus erythematosus

KW - SS = Sjögren syndrome

KW - XS = xerostomia

UR - http://www.scopus.com/inward/record.url?scp=0034995231&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034995231&partnerID=8YFLogxK

M3 - Article

C2 - 11393497

AN - SCOPUS:0034995231

VL - 76

SP - 593

EP - 599

JO - Mayo Clinic Proceedings

JF - Mayo Clinic Proceedings

SN - 0025-6196

IS - 6

ER -