{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:06:26Z","timestamp":1792202786532,"version":"4.4.0"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T00:00:00Z","timestamp":1575936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Juvenile Sj\u00f6gren's syndrome (<jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>) is a rare, poorly defined, and possibly underdiagnosed condition affecting children and adolescents. The aim of this study was to characterize symptoms and clinical findings of juvenile <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content> and to explore the clinical application of major salivary gland ultrasonography (<jats:styled-content style=\"fixed-case\">SGUS<\/jats:styled-content>) in patients with juvenile <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional multicenter study recruited patients with disease onset until age 18 years (n = 67). Disease characteristics were recorded, and unstimulated whole sialometry and <jats:styled-content style=\"fixed-case\">SGUS<\/jats:styled-content> examination of the parotid and submandibular salivary glands were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The female:male ratio was 58:9. The mean age at first symptom was 10.2 years and 12.1 years at diagnosis. Ocular and oral symptoms were noted in 42 of 67 patients (63%) and 53 of 66 patients (80%), respectively. The American\u2010European Consensus Group or American College of Rheumatology\/European League Against Rheumatism classification criteria for primary <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content> were fulfilled by 42 of 67 patients (63%). Pathologic <jats:styled-content style=\"fixed-case\">SGUS<\/jats:styled-content> findings were observed in 41 of 67 patients (61%); 26 of 41 <jats:styled-content style=\"fixed-case\">SGUS<\/jats:styled-content>+ patients (63%) fulfilled primary <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content> criteria. Salivary gland enlargements\/parotitis were noted in 37 of 58 patients and were nonsignificantly associated with <jats:styled-content style=\"fixed-case\">SGUS<\/jats:styled-content>+ status (<jats:italic>P<\/jats:italic> = 0.066). The mean levels of saliva were 5.6 ml\/15 minutes in <jats:styled-content style=\"fixed-case\">SGUS<\/jats:styled-content>\u2013 patients compared to 3.3 ml\/15 minutes in the <jats:styled-content style=\"fixed-case\">SGUS<\/jats:styled-content>+ patients (<jats:italic>P<\/jats:italic> = 0.049). A total of 36 of 41 <jats:styled-content style=\"fixed-case\">SGUS<\/jats:styled-content>+ patients (88%) were anti\u2010Ro\/La+ compared to 14 of 26 <jats:styled-content style=\"fixed-case\">SGUS<\/jats:styled-content>\u2013 patients (54%) (<jats:italic>P<\/jats:italic> = 0.001). In addition, 24 of 39 <jats:styled-content style=\"fixed-case\">SGUS<\/jats:styled-content>+ patients (62%) were positive for rheumatoid factor (<jats:styled-content style=\"fixed-case\">RF<\/jats:styled-content>), whereas only 5 of 25 <jats:styled-content style=\"fixed-case\">SGUS<\/jats:styled-content>\u2013 patients (20%) were <jats:styled-content style=\"fixed-case\">RF<\/jats:styled-content>+ (<jats:italic>P<\/jats:italic> = 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Juvenile <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content> is characterized by a large spectrum of clinical symptoms and findings. Several glandular and extraglandular parameters such as hyposalivation, swollen salivary glands, and autoantibodies are associated with pathologic <jats:styled-content style=\"fixed-case\">SGUS<\/jats:styled-content> findings.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23839","type":"journal-article","created":{"date-parts":[[2019,1,30]],"date-time":"2019-01-30T06:25:27Z","timestamp":1548829527000},"page":"78-87","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":61,"title":["Juvenile Sj\u00f6gren's Syndrome: Clinical Characteristics With Focus on Salivary Gland Ultrasonography"],"prefix":"10.1002","volume":"72","author":[{"given":"Daniel S.","family":"Hammenfors","sequence":"first","affiliation":[{"name":"University of Bergen and Haukeland University Hospital  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9ria","family":"Valim","sequence":"additional","affiliation":[{"name":"Federal University of Esp\u00edrito Santo  Vit\u00f3ria Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blanca E. 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G.","family":"Bica","sequence":"additional","affiliation":[{"name":"Hospital Universit\u00e1rio Clementino Fraga Filho Federal University of Rio de Janeiro  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra G.","family":"Pasoto","sequence":"additional","affiliation":[{"name":"Hospital das Clinicas Faculdade de Medicina da Universidade de Sao Paulo  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vibke","family":"Lilleby","sequence":"additional","affiliation":[{"name":"Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5971-4185","authenticated-orcid":false,"given":"Juan Carlos","family":"Nieto\u2010Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clovis A.","family":"Silva","sequence":"additional","affiliation":[{"name":"Hospital das Clinicas Faculdade de Medicina da Universidade de Sao Paulo  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Mossel","sequence":"additional","affiliation":[{"name":"University Medical Centre Groningen University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa M. 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