{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T10:52:51Z","timestamp":1782125571549,"version":"3.54.5"},"reference-count":60,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and Clinical Significance: Childhood-onset Sj\u00f6gren\u2019s disease (cSjD) is a rare autoimmune disorder that remains challenging to diagnose because of its heterogeneous clinical presentation and the frequent absence of classic sicca symptoms at disease onset. Recurrent parotitis and systemic manifestations often predominate in pediatric patients, contributing to diagnostic delay and potential irreversible glandular damage. Early recognition is essential to prevent complications and improve long-term outcomes. Case Presentation: We report the case of a 17-year-old female diagnosed with primary Sj\u00f6gren\u2019s disease following a prolonged history of recurrent parotid involvement and progressive glandular dysfunction. Comprehensive evaluation revealed positive anti-SSA antibodies, hypergammaglobulinemia, characteristic salivary gland ultrasonography abnormalities, and a positive minor salivary gland biopsy, resulting in fulfillment of all domains of the 2016 ACR\/EULAR classification criteria. The patient also exhibited unusual vascular findings, including carotid atheromatous calcifications in the absence of traditional cardiovascular risk factors. Conclusion: This case highlights the diagnostic complexity of cSjD and underscores the value of a multimodal diagnostic approach integrating clinical assessment, serology, imaging, and histopathology. The presence of early vascular abnormalities broadens the spectrum of potential extraglandular manifestations and emphasizes the need for comprehensive evaluation and long-term monitoring in affected patients.<\/jats:p>","DOI":"10.3390\/diagnostics16121926","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T09:49:55Z","timestamp":1782121795000},"page":"1926","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric Sj\u00f6gren\u2019s Disease: Literature Review and Diagnostic Challenges in an Uncommon Case"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5836-1517","authenticated-orcid":false,"given":"Otilia Elena","family":"Fr\u0103sinariu","sequence":"first","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drago\u0219 Florin","family":"Te\u0219oi","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9800-9289","authenticated-orcid":false,"given":"Anca","family":"Cardoneanu","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ileana Katerina","family":"Ioniuc","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5186-0858","authenticated-orcid":false,"given":"Ana Maria","family":"Scurtu","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7859-840X","authenticated-orcid":false,"given":"Elena","family":"Cojocaru","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larisa Ioana","family":"Te\u0219oi","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ionut Daniel","family":"Iancu","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anamaria Laura","family":"Buga","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrith Crengu\u021ba","family":"Miron","sequence":"additional","affiliation":[{"name":"Grigore T. 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Rheumatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3144","DOI":"10.1093\/rheumatology\/keaa757","article-title":"Childhood Sj\u00f6gren syndrome: Features of an international cohort and application of the 2016 ACR\/EULAR classification criteria","volume":"60","author":"Basiaga","year":"2020","journal-title":"Rheumatology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1186\/s12969-023-00902-y","article-title":"A single-center study of clinical features of pediatric Sj\u00f6gren\u2019s syndrome","volume":"21","author":"Hou","year":"2023","journal-title":"Pediatr. Rheumatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/s40001-021-00534-6","article-title":"Sj\u00f6gren\u2019s syndrome in children: About 15 cases in Guinea Conakry","volume":"26","author":"Guelngar","year":"2021","journal-title":"Eur. J. Med. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/S1079-2104(03)00159-8","article-title":"Primary sj\u00f6gren syndrome in childhood: Report of a case and review of the literature","volume":"96","author":"Nikitakis","year":"2003","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endodontol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"4558","DOI":"10.1093\/rheumatology\/keab032","article-title":"Childhood-onset of primary Sj\u00f6gren\u2019s syndrome: Phenotypic characterization at diagnosis of 158 children","volume":"60","author":"Vissink","year":"2021","journal-title":"Rheumatology"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Kelly, A.L., Nelson, R.J., Sara, R., and Alberto, S. (2022). Sj\u00f6gren Syndrome: New Insights in the Pathogenesis and Role of Nuclear Medicine. J. Clin. Med., 11.","DOI":"10.3390\/jcm11175227"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Huijser, E., van Helden-Meeuwsen, C.G., Grashof, D.G.B., Tarn, J.R., Brkic, Z., Huisman, J.M.A., Wahadat, M.J., van de Werken, H.J.G., Lopes, A.P., and van Roon, J.A.G. (2022). Trained Immunity in Primary Sj\u00f6gren\u2019s Syndrome: Linking Type I Interferons to a Pro-Atherogenic Phenotype. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.840751"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1136\/ard-2022-223628","article-title":"2022 EULAR points to consider for the measurement, reporting and application of IFN-I pathway activation assays in clinical research and practice","volume":"82","author":"Burska","year":"2023","journal-title":"Ann. Rheum. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e003800","DOI":"10.1136\/rmdopen-2023-003800","article-title":"Hyperactivation and altered selection of B cells in patients with paediatric Sjogren\u2019s syndrome","volume":"10","author":"Boni","year":"2024","journal-title":"RMD Open"},{"key":"ref_12","first-page":"2336","article-title":"Pathogenesis of Sj\u00f6gren\u2019s disease: One year in review 2024","volume":"42","author":"Baldini","year":"2024","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Liu, C., Jin, Y., Huang, H., Ding, F., Xu, X., Bao, S., Yang, Z., and Jin, Y. (2023). Clinical and laboratory features of childhood-onset primary Sj\u00f6gren\u2019s syndrome: A retrospective study from China. Front. Pediatr., 10.","DOI":"10.3389\/fped.2022.1044812"},{"key":"ref_14","first-page":"79","article-title":"Sj\u00f6gren syndrome in childhood mimicking pediatric multiple sclerosis","volume":"18","author":"Cavusoglu","year":"2023","journal-title":"J. Pediatr. Neurosci."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Song, Y., Sun, L., Cui, G., Feng, D., Sun, Q., and Wang, Y. (2025). Childhood-onset primary Sj\u00f6gren\u2019s Syndrome presenting as nephrotic syndrome: A case report and literature review. BMC Pediatr., 25.","DOI":"10.1186\/s12887-025-06029-1"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1007\/s00467-023-06135-1","article-title":"Kidney manifestations of pediatric Sj\u00f6gren\u2019s syndrome","volume":"39","author":"Bella","year":"2023","journal-title":"Pediatr. Nephrol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Bouchalova, K., Fl\u00f6gelova, H., Horak, P., Civrny, J., Mlcak, P., Pink, R., Michalek, J., Camborova, P., Mikulkova, Z., and Kriegova, E. (2024). Juvenile Primary Sj\u00f6gren Syndrome in a 15-Year-Old Boy with Renal Involvement: A Case Report and Review of the Literature. Diagnostics, 14.","DOI":"10.3390\/diagnostics14030258"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.3899\/jrheum.2024-1048","article-title":"Results of a nationwide multicenter study in childhood Sj\u00f6gren disease","volume":"52","author":"Ayduran","year":"2025","journal-title":"J. Rheumatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"109739","DOI":"10.1016\/j.clim.2023.109739","article-title":"Non-invasive diagnosis of primary Sj\u00f6gren\u2019s syndrome using ultrasonography and transcriptome biomarkers","volume":"255","author":"Xu","year":"2023","journal-title":"Clin. Immunol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"263","DOI":"10.3899\/jrheum.2023-0202","article-title":"The Novel OMERACT Ultrasound Scoring System for Salivary Gland Changes in Patients With Sj\u00f6gren Syndrome Is Associated With MRI and Salivary Flow Rates","volume":"51","author":"Inanc","year":"2024","journal-title":"J. Rheumatol."},{"key":"ref_21","first-page":"246","article-title":"Evaluation of Salivary Glands by Ultrasonography and Inflammatory Markers in Children with Autoimmune Thyroiditis","volume":"24","author":"Cengiz","year":"2023","journal-title":"Istanb. Med. J."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Marrani, E., Fulvio, G., Virgili, C., Izzetti, R., Dini, V., Oranges, T., Baldini, C., and Simonini, G. (2023). Ultra-High-Frequency Ultrasonography of Labial Glands in Pediatric Sj\u00f6gren\u2019s Disease: A Preliminary Study. Diagnostics, 13.","DOI":"10.3390\/diagnostics13162695"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Caraba, A., Roman, D., Cri\u0219an, V., Iurciuc, S., and Iurciuc, M. (2024). Salivary Flow Rate in Patients with Sj\u00f6gren\u2019s Syndrome: Correlations with Salivary Gland Ultrasound Findings and Biomarkers of Disease Activity. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26010101"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"209","DOI":"10.5624\/isd.20200313","article-title":"Three-dimensional cone-beam computed tomographic sialography in the diagnosis and management of primary Sj\u00f6gren syndrome: Report of 3 cases","volume":"51","author":"Thomas","year":"2021","journal-title":"Imaging Sci. Dent."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"van Ginkel, M.S., Glaudemans, A.W.J.M., van der Vegt, B., Mossel, E., Kroese, F.G.M., Bootsma, H., and Vissink, A. (2020). Imaging in Primary Sj\u00f6gren\u2019s Syndrome. J. Clin. Med., 9.","DOI":"10.3390\/jcm9082492"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Bertin, H., Bonnet, R., Le Thuaut, A., Huon, J.-F., Corre, P., Frampas, E., Langlois, E.M., and Chesneau, A.-S.D. (2023). A comparative study of three-dimensional cone-beam CT sialography and MR sialography for the detection of non-tumorous salivary pathologies. BMC Oral Health, 23.","DOI":"10.1186\/s12903-023-03159-9"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1111\/odi.12946","article-title":"Novel parotid sialo-cone-beam computerized tomography features in patients with suspected Sjogren\u2019s syndrome","volume":"25","author":"Keshet","year":"2018","journal-title":"Oral Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1002\/art.42723","article-title":"Increased Diagnostic Accuracy of the Labial Gland Biopsy in Primary Sj\u00f6gren Syndrome When Multiple Histopathological Features Are Included","volume":"76","author":"Nakshbandi","year":"2024","journal-title":"Arthritis Rheumatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1093\/rheumatology\/keab579","article-title":"Treatment strategies for Sj\u00f6gren\u2019s syndrome with childhood onset: A systematic review of the literature","volume":"61","author":"Doolan","year":"2022","journal-title":"Rheumatology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1186\/s12969-022-00740-4","article-title":"Pediatric rheumatologists\u2019 perspectives on diagnosis, treatment, and outcomes of Sj\u00f6gren disease in children and adolescents","volume":"20","author":"Randell","year":"2022","journal-title":"Pediatr. Rheumatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2897","DOI":"10.1007\/s10067-025-07486-w","article-title":"Multidimensional assessment of Juvenile Sj\u00f6gren disease","volume":"44","year":"2025","journal-title":"Clin. Rheumatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1186\/s12969-023-00870-3","article-title":"Long-term efficacy of sialendoscopy in treating childhood Sj\u00f6gren\u2019s disease with chronological monitoring by salivary gland ultrasonography: A novel approach","volume":"21","author":"Drew","year":"2023","journal-title":"Pediatr. Rheumatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1093\/rheumatology\/keae218","article-title":"Executive summary: British Society for Rheumatology guideline on management of adult and juvenile onset Sj\u00f6gren disease","volume":"64","author":"Price","year":"2024","journal-title":"Rheumatology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"3039","DOI":"10.1093\/rheumatology\/keae640","article-title":"Diagnosing a child presenting with symptoms suggesting Sj\u00f6gren\u2019s disease: A tool for clinical practice","volume":"64","author":"Stern","year":"2024","journal-title":"Rheumatology"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Soriano-Mart\u00edn, D., Garc\u00eda-Consuegra, L., Junquera, L., Reda, S., and Junquera, S. (2023). Juvenile Recurrent Parotitis: Video-Documented Sialendoscopy. J. Clin. Med., 12.","DOI":"10.3390\/jcm12216842"},{"key":"ref_36","first-page":"53","article-title":"Sialendoscopy approach in treating juvenile recurrent parotitis: A systematic review","volume":"52","author":"Junquera","year":"2023","journal-title":"J. Otolaryngol.\u2014Head Neck Surg. J. D\u2019oto-Rhino-Laryngol. Chir. Cervico-Faciale"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.otc.2021.02.002","article-title":"IgG4-Related Disease and the Salivary Glands","volume":"54","author":"Skillington","year":"2021","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Arias-Intriago, M., Gomolin, T., Jaramillo, F., Cruz-Enr\u00edquez, A.C., Lara-Arteaga, A.L., Tello-De-la-Torre, A., Ortiz-Prado, E., and Izquierdo-Condoy, J.S. (2025). IgG4-Related Disease: Current and Future Insights into Pathological Diagnosis. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26115325"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Abouseif, N., Jaber, M., and Abdelsayed, R.B. (2025). Salivary Gland Sarcoidosis: Systematic Review of Case Reports and Case Series. J. Clin. Med., 14.","DOI":"10.3390\/jcm14217539"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"61","DOI":"10.30574\/msarr.2021.3.2.0089","article-title":"Effects of cystic fibrosis on the oral cavity","volume":"3","author":"Goumghar","year":"2021","journal-title":"Magna Sci. Adv. Res. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1186\/s13075-022-02959-8","article-title":"Expression of CFTR, a hallmark gene of ionocytes, is downregulated in salivary glands of Sj\u00f6gren\u2019s syndrome patients","volume":"24","author":"Zhang","year":"2022","journal-title":"Arthritis Res. Ther."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.reuma.2017.01.015","article-title":"Extranodal marginal zone B cell lymphoma: An unexpected complication in children with Sj\u00f6gren\u2019s syndrome","volume":"14","author":"Collado","year":"2017","journal-title":"Reumatol. Cl\u00edn."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"109768","DOI":"10.1016\/j.ijporl.2019.109768","article-title":"Sj\u00f6gren\u2019s syndrome in children with recurrent parotitis","volume":"129","author":"Schiffer","year":"2020","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_44","unstructured":"Rausch-Phung, E.A., Davison, P., and Morris, J. (2024). Mumps. StatPearls, StatPearls Publishing."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Spampinato, S., Pavone, P., Cacciaguerra, G., Cocuzza, S., Venanzi Rullo, E., Marino, S., Marino, A., and Nunnari, G. (2023). Coronavirus OC43 and Influenza H3N2 Concomitant Unilateral Parotitis: The Importance of Laboratory Tests in Mumps-Like Parotitis. Pathogens, 12.","DOI":"10.3390\/pathogens12111309"},{"key":"ref_46","first-page":"147","article-title":"Salivary Gland Ultrasound in Primary Sj\u00f6gren\u2019s Syndrome: Current and Future Perspectives","volume":"14","author":"Lorenzon","year":"2022","journal-title":"Open Access Rheumatol. Res. Rev."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Koch, M., Sievert, M., Iro, H., Mantsopoulos, K., and Schapher, M. (2021). Ultrasound in Inflammatory and Obstructive Salivary Gland Diseases: Own Experiences and a Review of the Literature. J. Clin. Med., 10.","DOI":"10.3390\/jcm10163547"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1586","DOI":"10.1093\/rheumatology\/keac470","article-title":"Predicting lymphoma in Sj\u00f6gren\u2019s syndrome and the pathogenetic role of parotid microenvironment through precise parotid swelling recording","volume":"62","author":"Isola","year":"2023","journal-title":"Rheumatology"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"102062","DOI":"10.1016\/j.eclinm.2023.102062","article-title":"Mortality risk factors in primary Sj\u00f6gren syndrome: A real-world, retrospective, cohort study","volume":"61","author":"Horvath","year":"2023","journal-title":"eClinicalMedicine"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e279","DOI":"10.1016\/S2665-9913(24)00059-6","article-title":"The Florida Scoring System for stratifying children with suspected Sj\u00f6gren\u2019s disease: A cross-sectional machine learning study","volume":"6","author":"Zeng","year":"2024","journal-title":"Lancet Rheumatol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e255","DOI":"10.1016\/S2665-9913(24)00088-2","article-title":"A new tool for stratifying children with suspected Sj\u00f6gren\u2019s disease","volume":"6","author":"Ciurtin","year":"2024","journal-title":"Lancet Rheumatol."},{"key":"ref_52","first-page":"2344","article-title":"Outcome measure in childhood Sj\u00f6gren\u2019s disease: Where do we stand?","volume":"42","author":"Marrani","year":"2024","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"20","DOI":"10.5152\/eurjrheum.2021.20093","article-title":"Primary Sj\u00f6gren\u2019s syndrome as independent risk factor for subclinical atherosclerosis","volume":"9","year":"2022","journal-title":"Eur. J. Rheumatol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.ejim.2023.11.007","article-title":"Risk of subclinical atherosclerosis in primary Sjogren\u2019s syndrome: A systematic review and meta-analysis","volume":"122","author":"Karakasis","year":"2024","journal-title":"Eur. J. Intern. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e003559","DOI":"10.1136\/rmdopen-2023-003559","article-title":"Primary Sj\u00f6gren\u2019s syndrome independently promotes premature subclinical atherosclerosis","volume":"10","author":"Zehrfeld","year":"2024","journal-title":"RMD Open"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Behbodikhah, J., Ding, B., Jacob, B., Batool, N., Belilos, E., De Leon, J., Carsons, S.E., and Reiss, A.B. (2025). Sjogren\u2019s Disease and Elevated Cardiovascular Risk: Mechanisms and Treatment. J. Cardiovasc. Dev. Dis., 12.","DOI":"10.3390\/jcdd12090367"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Atzeni, F., Gozza, F., Cafaro, G., Perricone, C., and Bartoloni, E. (2022). Cardiovascular Involvement in Sj\u00f6gren\u2019s Syndrome. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.879516"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1186\/s13075-025-03625-5","article-title":"Oscillometric, greyscale- and novel color-Doppler-ultrasound indices of macrovascular damage in Sj\u00f6gren\u2019s: The SICARD cohort study","volume":"27","author":"Triantafyllias","year":"2025","journal-title":"Arthritis Res. Ther."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1177\/0022034510390811","article-title":"Salivary anti-Ro60 and anti-Ro52 Antibody Profiles to Diagnose Sj\u00f6gren\u2019s Syndrome","volume":"90","author":"Ching","year":"2011","journal-title":"J. Dent. Res."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1016\/j.ard.2025.03.012","article-title":"A cross-sectional observational study of patients with sicca with salivary autoantibodies defines a potential new phenotype of Sj\u00f6gren\u2019s disease","volume":"84","author":"Tsaliki","year":"2025","journal-title":"Ann. Rheum. Dis."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/12\/1926\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T10:35:06Z","timestamp":1782124506000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/12\/1926"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":60,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["diagnostics16121926"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16121926","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,22]]}}}