Results of a Nationwide Multicenter Study in Childhood Sjögren Disease
Gülşah Kılbaş, Semra Ayduran, Seher Şener, Taner Çoşkuner, Kadir Ulu, Hakan Kısaoğlu, Esma Aslan, Elif Kılıç Könte, Ceyda Arslanaoğlu, Tuncay Aydın, Yağmur Şadırvan Oğuzkaya, Figen Çakmak, Deniz Gezgin Yıldırım, Melike Mehveş Kaplan, Saadet Nilay Tığrak, Serkan Türkuçar, Hafize Emine Sönmez, Rabia Miray Kışla Ekinci, Kübra Öztürk, Ferhat Demir, Esra Bağlan, Burcu Yücel Bozkaya, Sema Nur Taşkın, Selcan Demir, Erdal Sağ, Ezgi Deniz Batu, Sezgin Şahin, Sevcan A Bakkaloğlu Ezgü, Sara Şebnem Kılıç, Ayşenur Paç Kısaarslan, Banu Çelikel Acar, Mukaddes Kalyoncu, Nuray Aktay Ayaz, Betül Sözeri, Erbil Ünsal, Özgür Kasapçopur, Seza Özen, Selçuk Yüksel
Abstract
Objective This nationwide, multicenter study was conducted to assess the demographic and clinical features, treatment regimens, and prognosis of primary Sjögren disease (SjD) in childhood. Methods This retrospective study included a total of 81 patients < 18 years of age from 21 pediatric rheumatology centers. Among these, 51 patients fulfilled the diagnosis of childhood SjD according to the 2016 American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) classification criteria. The remaining 30 patients—who did not fully meet these criteria but exhibited clinical and laboratory findings suggestive of SjD—were categorized as at risk for childhood SjD to highlight diagnostic challenges and the spectrum of early presentations, based on comprehensive clinical evaluation by experienced pediatric rheumatologists. Results The cohort consisted of 81 patients (85.2% female, 14.8% male) with a median age at symptom onset of 11.4 years and a median follow-up of 24 months. Common clinical manifestations included dry mouth, dry eyes, arthralgia, fatigue, and parotitis. Fifty-one of the 81 patients met the 2016 ACR/EULAR classification criteria, whereas the remaining 30 were classified as an at-risk group. The most common clinical findings in the at-risk group were xerostomia (90%), arthralgia (56.7%), fatigue (50%), and dry eyes (43.3%). Dry mouth and peripheral nervous system involvements were found to be higher in patients categorized as at risk ( P = 0.03 and P = 0.02, respectively). Conclusion The current classification criteria for childhood SjD appear to be inadequate, highlighting the need for pediatric-specific criteria that more accurately reflect the distinct clinical patterns observed in children.