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Table 1 AECG versus ACR/EULAR criteria

From: Comparison of 2002 AECG and 2016 ACR/EULAR classification criteria and added value of salivary gland ultrasonography in a patient cohort with suspected primary Sjögren’s syndrome

  2002 AECG criteria 2016 ACR/EULAR criteria
Items 1. Ocular dryness symptoms
2. Oral dryness symptoms
3. Ocular signs: Schirmer’s test ≤ 5 mm/5 min or van Bijsterveld score ≥ 4
4. Focus score ≥ 1 foci/4 mm2 on minor salivary gland biopsy
5. Salivary gland involvement: unstimulated whole salivary flow ≤ 0.1 mL/min
6. Positive anti-SSA or SSB antibodies
1. Labial salivary gland with focal lymphocytic sialadenitis and focus score of ≥ 1 foci/4 mm2 3
2. Anti-SSA/Ro-positive 3
3. Ocular Staining Score ≥ 5 (or van Bijsterveld score ≥ 4) in at least one eye 1
4. Schirmer’s test ≤ 5 mm/5 min in at least one eye 1
5. Unstimulated whole saliva flow rate ≤ 0.1 mL/min 1
Rules for classification − Absence of exclusion criteriaa
− Presence of any 4 of the 6 items with at least item 4 or 6, or
− presence of any 3 of the 4 objective items (3, 4, 5, and 6)
Applies to any individual
− who meets the inclusion criteriab with at least one symptom of ocular or oral dryness or ESSDAI ≥ 1
− does not have any of the conditions listed as exclusion criteriac
− and has a score of ≥ 4 when the weights from the 5 criteria items are summed
  1. AECG American-European Consensus Group, ACR American College of Rheumatology, SS Sjögren’s syndrome, ESSDAI EULAR SS Disease Activity Index, anti-SSA anti-Sjögren's-syndrome-related antigen A
  2. aExclusion criteria in the AECG system: past head and neck radiation treatment, hepatitis C infection, acquired immunodeficiency syndrome (AIDS), pre-existing lymphoma, sarcoidosis, graft-versus-host disease, use of anticholinergic drugs (within a time shorter than fourfold the half-life of the drug)
  3. bThese criteria are applicable to any patient with at least one symptom of ocular or oral dryness or in whom there is a suspicion of Sjögren’s syndrome (SS) based on the ESSDAI (at least one domain with a positive item).
  4. cExclusion criteria for ACR/EULAR criteria include a prior diagnosis of any of the following conditions, which would exclude diagnosis of SS and participation in SS studies or therapeutic trials because of overlapping clinical features or interference with criteria tests: history of head and neck radiation treatment, active hepatitis C infection (with confirmation by PCR), AIDS, sarcoidosis, amyloidosis, graft-versus-host disease, and IgG4-related disease