Comment suivre un patient atteint du syndrome de Sjögren ?

Abstract

In primary Sjögren's syndrome (pSS), patients may present with heterogeneous symptoms. The triad of characteristic symptoms is frequent and includes dryness, fatigue, and pain. Also, 30 to 40% of patients may develop systemic damage. Thus, pSS patients’ follow-up is individualized and must be adapted to the patient clinical and biological phenotype. The modalities and the frequency of the follow-up depend on the presence or not of systemic complications, or their risk factors. As pSS is a rare disease, it is recommended to organize its management in collaboration with reference centers. pSS management is multidisciplinary and involves different health professionals depending on the initial damage characteristics and the evolution. The aim of the follow-up is to determine the activity and severity of the disease, as well as to detect occurrence of systemic complications. It assesses the efficacy and tolerance of treatments and includes the search for comorbidities. In addition, risk factors of lymphoma must be regularly reassessed. Regular monitoring of ophthalmologic and oral status is required. Recent EULAR guidelines address the management of the triad of dryness, fatigue and pain, and detail the management of systemic involvement. In addition, the “Protocole National de Diagnostic et de Soins” has been recently established and presents a clear strategy for patient management and follow-up. Finally, therapeutic education is a pillar of pSS management, allowing patients to be active in their disease follow-up.