Revisión sistemática: factores asociados a enfermedad pulmonar intersticial fibrosante progresiva en pacientes con Síndrome de Sjögren

La enfermedad pulmonar es una manifestación común en las enfermedades autoinmunes. Se desarrollo una revisión sistemática de literatura. Se seleccionaron 8 estudios de alta calidad, diseño de casos y controles. Entre el 20,4 – 52,9% de la población con EPI en SS cumplía criterios de fibrosis pulmona...

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2024
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Universidad del Rosario
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Repositorio EdocUR - U. Rosario
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spa
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https://repository.urosario.edu.co/handle/10336/44497
Palabra clave:
Síndrome de Sjögren
Enfermedad pulmonar intersticial
Fibrosis pulmonar
Factores de riesgo
Revisión sistemática
Sjögren's Syndrome
Interstitial lung disease
Pulmonary fibrosis
Risk factors
Systematic review
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network_acronym_str EDOCUR2
network_name_str Repositorio EdocUR - U. Rosario
repository_id_str
dc.title.none.fl_str_mv Revisión sistemática: factores asociados a enfermedad pulmonar intersticial fibrosante progresiva en pacientes con Síndrome de Sjögren
dc.title.TranslatedTitle.none.fl_str_mv Systematic review: Factors associated with progressive fibrosing interstitial lung disease in patients with Sjögren's Syndrome
title Revisión sistemática: factores asociados a enfermedad pulmonar intersticial fibrosante progresiva en pacientes con Síndrome de Sjögren
spellingShingle Revisión sistemática: factores asociados a enfermedad pulmonar intersticial fibrosante progresiva en pacientes con Síndrome de Sjögren
Síndrome de Sjögren
Enfermedad pulmonar intersticial
Fibrosis pulmonar
Factores de riesgo
Revisión sistemática
Sjögren's Syndrome
Interstitial lung disease
Pulmonary fibrosis
Risk factors
Systematic review
title_short Revisión sistemática: factores asociados a enfermedad pulmonar intersticial fibrosante progresiva en pacientes con Síndrome de Sjögren
title_full Revisión sistemática: factores asociados a enfermedad pulmonar intersticial fibrosante progresiva en pacientes con Síndrome de Sjögren
title_fullStr Revisión sistemática: factores asociados a enfermedad pulmonar intersticial fibrosante progresiva en pacientes con Síndrome de Sjögren
title_full_unstemmed Revisión sistemática: factores asociados a enfermedad pulmonar intersticial fibrosante progresiva en pacientes con Síndrome de Sjögren
title_sort Revisión sistemática: factores asociados a enfermedad pulmonar intersticial fibrosante progresiva en pacientes con Síndrome de Sjögren
dc.contributor.advisor.none.fl_str_mv Ospina Medina, María Cristina
Gómez Mora, Danny Alexis
dc.subject.none.fl_str_mv Síndrome de Sjögren
Enfermedad pulmonar intersticial
Fibrosis pulmonar
Factores de riesgo
Revisión sistemática
topic Síndrome de Sjögren
Enfermedad pulmonar intersticial
Fibrosis pulmonar
Factores de riesgo
Revisión sistemática
Sjögren's Syndrome
Interstitial lung disease
Pulmonary fibrosis
Risk factors
Systematic review
dc.subject.keyword.none.fl_str_mv Sjögren's Syndrome
Interstitial lung disease
Pulmonary fibrosis
Risk factors
Systematic review
description La enfermedad pulmonar es una manifestación común en las enfermedades autoinmunes. Se desarrollo una revisión sistemática de literatura. Se seleccionaron 8 estudios de alta calidad, diseño de casos y controles. Entre el 20,4 – 52,9% de la población con EPI en SS cumplía criterios de fibrosis pulmonar progresiva (EPI-FP). Los factores de riesgo estadísticamente significativos observados son la edad mayor a 60 años, en un 81% de los casos la EPI-FP inicia antes o al momento del diagnóstico de la EPI en SS. Manifestaciones clínicas como el fenómeno de Raynaud y manifestaciones gastrointestinales (57,1%) y la hipoalbuminemia también se identificaron como factores de riesgo. El patrón NIU fue indicador de progresión de la fibrosis. En conclusión, se identificó que la edad avanzada, la presencia de EPI antes o al momento del diagnóstico del SS, manifestaciones gastrointestinales, hipoalbuminemia, niveles elevados de LDH, VSG y el patrón tomográfico NIU se encuentran con mayor frecuencia en pacientes con EPI-FP en SS.
publishDate 2024
dc.date.accessioned.none.fl_str_mv 2024-12-09T21:00:35Z
dc.date.available.none.fl_str_mv 2024-12-09T21:00:35Z
dc.date.created.none.fl_str_mv 2024-12-08
dc.type.none.fl_str_mv bachelorThesis
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_7a1f
dc.type.spa.none.fl_str_mv Trabajo de grado
dc.identifier.uri.none.fl_str_mv https://repository.urosario.edu.co/handle/10336/44497
url https://repository.urosario.edu.co/handle/10336/44497
dc.language.iso.none.fl_str_mv spa
language spa
dc.rights.*.fl_str_mv Attribution-NonCommercial-ShareAlike 4.0 International
dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.acceso.none.fl_str_mv Abierto (Texto Completo)
dc.rights.uri.*.fl_str_mv http://creativecommons.org/licenses/by-nc-sa/4.0/
rights_invalid_str_mv Attribution-NonCommercial-ShareAlike 4.0 International
Abierto (Texto Completo)
http://creativecommons.org/licenses/by-nc-sa/4.0/
http://purl.org/coar/access_right/c_abf2
dc.format.extent.none.fl_str_mv 55 pp
dc.format.mimetype.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidad del Rosario
Universidad CES. Facultad de Medicina
dc.publisher.department.none.fl_str_mv Escuela de Medicina y Ciencias de la Salud
dc.publisher.program.none.fl_str_mv Especialización en Epidemiología
publisher.none.fl_str_mv Universidad del Rosario
Universidad CES. Facultad de Medicina
institution Universidad del Rosario
dc.source.bibliographicCitation.none.fl_str_mv Brito-Zerón P, Baldini C, Bootsma H, Bowman SJ, Jonsson R, Mariette X, et al. Sjögren syndrome. Nat Rev Dis Primers. 2016 Jul 7;2.
Londoño J, Peláez Ballestas I, Cuervo F, Angarita I, Giraldo R, Rueda JC, et al. Prevalencia de la enfermedad reumática en Colombia, según estrategia COPCORD-Asociación Colombiana de Reumatología. Estudio de prevalencia de enfermedad reumática en población colombiana mayor de 18 años. Revista Colombiana de Reumatología. 2018;25(4):245–56.
Fischer A, Distler J. Progressive fibrosing interstitial lung disease associated with systemic autoimmune diseases. Clin Rheumatol. 2019;38(10):2673–81.
Nannini C, Jebakumar AJ, Crowson CS, Ryu JH, Matteson EL. Primary Sjögren’s syndrome 1976-2005 and associated interstitial lung disease: A populationbased study of incidence and mortality. BMJ Open. 2013;3(11).
Nannini C, Jebakumar AJ, Crowson CS, Ryu JH, Matteson EL. Primary Sjögren’s syndrome 1976-2005 and associated interstitial lung disease: A populationbased study of incidence and mortality. BMJ Open. 2013;3(11).
Chung A, Wilgus ML, Fishbein G, Lynch JP. Pulmonary and Bronchiolar Involvement in Sjogren’s Syndrome. Vol. 40, Seminars in Respiratory and Critical Care Medicine. Thieme Medical Publishers, Inc.; 2019. p. 235–54.
Parambil JG, Myers JL, Lindell RM, Matteson EL, Ryu JH. Interstitial lung disease in primary Sjögren syndrome. Chest. 2006;130(5):1489–95.
Shah Gupta R, Koteci A, Morgan A, George PM, Quint JK. Incidence and prevalence of interstitial lung diseases worldwide: A systematic literature review. Vol. 10, BMJ Open Respiratory Research. BMJ Publishing Group; 2023
Spagnolo P, Distler O, Ryerson CJ, Tzouvelekis A, Lee JS, Bonella F, et al. Mechanisms of progressive fibrosis in connective tissue disease (CTD)- associated interstitial lung diseases (ILDs). Ann Rheum Dis. 2021;80(2):143–50.
Brito-Zerón P, Kostov B, Solans R, Fraile G, Suárez-Cuervo C, Casanovas A, et al. Systemic activity and mortality in primary Sjögren syndrome: Predicting survival using the EULAR-SS Disease Activity Index (ESSDAI) in 1045 patients. Ann Rheum Dis. 2016;75(2):348–55.
Maqhuzu PN, Szentes BL, Kreuter M, Bahmer T, Kahn N, Claussen M, et al. Determinants of health-related quality of life decline in interstitial lung disease. Health Qual Life Outcomes. 2020 Oct 8;18(1).
Ley B, Collard HR. Epidemiology of idiopathic pulmonary fibrosis. Vol. 5, Clinical Epidemiology. 2013. p. 483–92.
Zheng Q, Cox IA, Campbell JA, Xia Q, Otahal P, de Graaff B, et al. Mortality and survival in idiopathic pulmonary fibrosis: a systematic review and meta-analysis. Vol. 8, ERJ Open Research. European Respiratory Society; 2022
Fischer A, Antoniou KM, Brown KK, Cadranel J, Corte TJ, Du Bois RM, et al. An official European Respiratory Society/American Thoracic Society research statement: Interstitial pneumonia with autoimmune features. In: European Respiratory Journal. European Respiratory Society; 2015. p. 976–87.
Wijsenbeek M, Kreuter M, Olson A, Fischer A, Bendstrup E, Wells CD, et al. Progressive fibrosing interstitial lung diseases: current practice in diagnosis and management. Curr Med Res Opin. 2019 Nov 2;35(11):2015–24.
He C, Chen Z, Liu S, Chen H, Zhang F. Prevalence and risk factors of interstitial lung disease in patients with primary Sjögren’s syndrome: A systematic review and meta-analysis. Vol. 23, International Journal of Rheumatic Diseases. Blackwell Publishing; 2020. p. 1009–18.
Xu Y, Zhou J, Dong X, Guo X, Lu Y, Zheng Y. Risk factors for progression and prognosis of primary Sjögren’s syndrome-associated interstitial lung disease in a Chinese population. Int J Rheum Dis. 2020 Dec 1;23(12):1734–40.
Richeldi L, Ryerson CJ, Lee JS, Wolters PJ, Koth LL, Ley B, et al. Relative versus absolute change in forced vital capacity in idiopathic pulmonary fibrosis. Thorax. 2012;67(5):407–11.
Fayyaz A, Kurien BT, Scofield RH. Autoantibodies in Sjögren’s Syndrome. Rheum Dis Clin North Am. 2016 Aug 1;42(3):419–34.
Anaya JM, Talal N. Sjögren’s Syndrome Comes of Age. Semin Arthritis Rheum. 1999;28(6):355–9.
Moutsopoulos HM. Sjögren´s Syndrome autoimmune epithelitis. Clinical Immunology and Inmmunopathology. 1994;72(2):162–5.
Goules A V., Tzioufas AG. Primary Sjögren’s syndrome: Clinical phenotypes, outcome and the development of biomarkers. Vol. 15, Autoimmunity Reviews. Elsevier B.V.; 2016. p. 695–703.
Qin B, Wang J, Yang Z, Yang M, Ma N, Huang F, et al. Epidemiology of primary Sjögren’s syndrome: A systematic review and meta-analysis. Vol. 74, Annals of the Rheumatic Diseases. BMJ Publishing Group; 2015. p. 1983–9.
Restrepo-Jiménez P, Molano-González N, Anaya JM. Geoepidemiology of Sjögren’s syndrome in Latin America. Joint Bone Spine. 2019 Oct 1;86(5):620– 6.
Shiboski CH, Shiboski SC, Seror R, Criswell LA, Labetoulle M, Lietman TM, et al. 2016 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Primary Sjögren’s Syndrome: A Consensus and Data-Driven Methodology Involving Three International Patient Cohorts. Arthritis and Rheumatology. 2017 Jan 1;69(1):35–45.
Fisher BA, Jonsson R, Daniels T, Bombardieri M, Brown RM, Morgan P, et al. Standardisation of labial salivary gland histopathology in clinical trials in primary Sjögren’s syndrome. Ann Rheum Dis. 2017 Jul 1;76(7):1161–8.
Travis WD, Costabel U, Hansell DM, King TE, Lynch DA, Nicholson AG, et al. An official American Thoracic Society/European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2013 Sep 15;188(6):733–48.
Raghu G, Chen SY, Hou Q, Yeh WS, Collard HR. Incidence and prevalence of idiopathic pulmonary fibrosis in US adults 18-64 years old. European Respiratory Journal. 2016 Jul 1;48(1):179–86.
Antin-Ozerkis D, Hinchcliff M. Connective Tissue Disease-Associated Interstitial Lung Disease: Evaluation and Management. Clin Chest Med. 2019 Sep 1;40(3):617–36.
Levi Y, Israeli-Shani L, Kuchuk M, Shochet GE, Koslow M, Shitrit D. Rheumatological assessment is important for interstitial lung disease diagnosis. Journal of Rheumatology. 2018 Nov 1;45(11):1509–14.
Raghu G, Remy-Jardin M, Richeldi L, Thomson CC, Antoniou KM, Bissell BD, et al. Idiopathic Pulmonary Fibrosis (an Update) and Progressive Pulmonary Fibrosis in Adults: An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med. 2022 May 1;205(9):E18–47.
Hambly N, Farooqi MM, Dvorkin-Gheva A, Donohoe K, Garlick K, Scallan C, et al. Prevalence and characteristics of progressive fibrosing interstitial lung disease in a prospective registry. Eur Respir J. 2022 Oct 1;60(4).
Barnett J, Devaraj A. Computed Tomographic Imaging in Connective Tissue Diseases. Semin Respir Crit Care Med. 2019;40(2):159–72.
Arrossi A V. Pulmonary Pathology in Rheumatic Disease. Clin Chest Med. 2019 Sep 1;40(3):667–77.
Ramos-Casals M, Brito-Zerón P, Bombardieri S, Bootsma H, De Vita S, Dörner T, et al. EULAR recommendations for the management of Sjögren’s syndrome with topical and systemic therapies. Ann Rheum Dis. 2020 Jan 1;79(1):3–18.
Lee AS, Scofield RH, Hammitt KM, Gupta N, Thomas DE, Moua T, et al. Consensus Guidelines for Evaluation and Management of Pulmonary Disease in Sjögren’s. In: Chest. Elsevier Inc.; 2021. p. 683–98.
Brown KK, Martinez FJ, Walsh SLF, Thannickal VJ, Prasse A, Schlenker-Herceg R, et al. The natural history of progressive fibrosing interstitial lung diseases. European Respiratory Journal. 2020 May 1;55(5).
Instituto de Evaluación Tecnológica en Salud – IETS. Manual metodológico para la elaboración de evaluaciones de efectividad clínica, seguridad y validez diagnóstica de tecnologías en salud. 2020. 136 p.
Higgins J, Green S. Chapter 22: Overview of reviews. Cochrane handbook for systematic reviews of interventions. Cochrane Database Syst Rev; 2008. 187– 235 p.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. Vol. 372, The BMJ. BMJ Publishing Group; 2021
Roca F, Dominique S, Schmidt J, Smail A, Duhaut P, Lévesque H, et al. Interstitial lung disease in primary Sjögren’s syndrome. Vol. 16, Autoimmunity Reviews. Elsevier B.V.; 2017. p. 48–54.
Chen YH, Lee TJ, Hsieh HJ, Hsieh SC, Wang HC, Chang YC, et al. Clinical outcomes and risk factors of progressive pulmonary fibrosis in primary Sjögren’s syndrome-associated interstitial lung disease. BMC Pulm Med. 2023 Dec 1;23(1).
He SH, He YJ, Guo KJ, Liang X, Li SS, Li TF. Risk factors for progression of interstitial lung disease in Sjögren’s syndrome: a single-centered, retrospective study. Clin Rheumatol. 2022 Apr 1;41(4):1153–61.
Zhang T, Yuan F, Xu L, Sun W, Liu L, Xue J. Characteristics of patients with primary Sjögren’s syndrome associated interstitial lung disease and relevant features of disease progression. Clin Rheumatol. 2020 May 1;39(5):1561–8.
Xu Y, Zhou J, Dong X, Guo X, Lu Y, Zheng Y. Risk factors for progression and prognosis of primary Sjögren’s syndrome-associated interstitial lung disease in a Chinese population. Int J Rheum Dis. 2020 Dec 1;23(12):1734–40.
Li D, Li H, Wang Y, Zhu T. Pulmonary fibrosis in primary Sjögren syndrome: computed tomography, clinical features, and associated clinical factors. Pol Arch Intern Med. 2023 Feb 27;133(2).
Lee KA, Nam B Da, Hwang JH, Kim HS. Clinical course and risk factors for development and progression of interstitial lung disease in primary Sjögren’s syndrome. Sci Rep. 2023 Dec 1;13(1).
Manfredi A, Vacchi C, DellaCasa G, Cerri S, Cassone G, Di Cecco G, et al. Fibrosing interstitial lung disease in primary Sjogren syndrome. Joint Bone Spine. 2021 Dec 1;88(6).
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spelling Ospina Medina, María Cristina4d505e32-5b3c-44a6-bb9c-662058c39ac2-1Gómez Mora, Danny Alexisfff0c614-610e-4c12-95e9-33ad8f0647a1-1Cuervo Gutiérrez, Francy MilenaRincón Álvarez, Emily KarinaEspecialista en Epidemiología (en Convenio con el CES)Especializacióna2aca6ee-0093-4135-b384-4cb743a3018f-170bfe7a5-c96b-4840-931a-d4639068cca7-12024-12-09T21:00:35Z2024-12-09T21:00:35Z2024-12-08La enfermedad pulmonar es una manifestación común en las enfermedades autoinmunes. Se desarrollo una revisión sistemática de literatura. Se seleccionaron 8 estudios de alta calidad, diseño de casos y controles. Entre el 20,4 – 52,9% de la población con EPI en SS cumplía criterios de fibrosis pulmonar progresiva (EPI-FP). Los factores de riesgo estadísticamente significativos observados son la edad mayor a 60 años, en un 81% de los casos la EPI-FP inicia antes o al momento del diagnóstico de la EPI en SS. Manifestaciones clínicas como el fenómeno de Raynaud y manifestaciones gastrointestinales (57,1%) y la hipoalbuminemia también se identificaron como factores de riesgo. El patrón NIU fue indicador de progresión de la fibrosis. En conclusión, se identificó que la edad avanzada, la presencia de EPI antes o al momento del diagnóstico del SS, manifestaciones gastrointestinales, hipoalbuminemia, niveles elevados de LDH, VSG y el patrón tomográfico NIU se encuentran con mayor frecuencia en pacientes con EPI-FP en SS.Interstitial lung disease (ILD) is a common manifestation in autoimmune diseases. This study is a systematic literature review. Eight high-quality case-control studies were selected. Between 20.4 - 52.9% of the population with SS-ILD meets criteria for progressive pulmonary fibrosis (PFILD). Statistically significant risk factors observed include age over 60 years, also, in 81% of cases FP-ILD begins before or at the time of diagnosis of SS-ILD. Clinical manifestations such as Raynaud's phenomenon, gastrointestinal symptoms (57.1%) and hypoalbuminemia were indicators of progression. The UIP pattern at CT was an indicator of FP-ILD. In conclusion, the reviewed studies highlight advanced age, debut of ILD before or at the time of diagnosis of SS, gastrointestinal manifestations, hypoalbuminemia, elevated levels of LDH, ESR, and the UIP tomographic pattern were found more frequently in patients with FP-ILD-SS.55 ppapplication/pdfhttps://repository.urosario.edu.co/handle/10336/44497spaUniversidad del RosarioUniversidad CES. Facultad de MedicinaEscuela de Medicina y Ciencias de la SaludEspecialización en EpidemiologíaAttribution-NonCommercial-ShareAlike 4.0 InternationalAbierto (Texto Completo)http://creativecommons.org/licenses/by-nc-sa/4.0/http://purl.org/coar/access_right/c_abf2Brito-Zerón P, Baldini C, Bootsma H, Bowman SJ, Jonsson R, Mariette X, et al. Sjögren syndrome. Nat Rev Dis Primers. 2016 Jul 7;2.Londoño J, Peláez Ballestas I, Cuervo F, Angarita I, Giraldo R, Rueda JC, et al. Prevalencia de la enfermedad reumática en Colombia, según estrategia COPCORD-Asociación Colombiana de Reumatología. Estudio de prevalencia de enfermedad reumática en población colombiana mayor de 18 años. Revista Colombiana de Reumatología. 2018;25(4):245–56.Fischer A, Distler J. Progressive fibrosing interstitial lung disease associated with systemic autoimmune diseases. Clin Rheumatol. 2019;38(10):2673–81.Nannini C, Jebakumar AJ, Crowson CS, Ryu JH, Matteson EL. Primary Sjögren’s syndrome 1976-2005 and associated interstitial lung disease: A populationbased study of incidence and mortality. BMJ Open. 2013;3(11).Nannini C, Jebakumar AJ, Crowson CS, Ryu JH, Matteson EL. Primary Sjögren’s syndrome 1976-2005 and associated interstitial lung disease: A populationbased study of incidence and mortality. BMJ Open. 2013;3(11).Chung A, Wilgus ML, Fishbein G, Lynch JP. Pulmonary and Bronchiolar Involvement in Sjogren’s Syndrome. Vol. 40, Seminars in Respiratory and Critical Care Medicine. Thieme Medical Publishers, Inc.; 2019. p. 235–54.Parambil JG, Myers JL, Lindell RM, Matteson EL, Ryu JH. Interstitial lung disease in primary Sjögren syndrome. Chest. 2006;130(5):1489–95.Shah Gupta R, Koteci A, Morgan A, George PM, Quint JK. Incidence and prevalence of interstitial lung diseases worldwide: A systematic literature review. Vol. 10, BMJ Open Respiratory Research. BMJ Publishing Group; 2023Spagnolo P, Distler O, Ryerson CJ, Tzouvelekis A, Lee JS, Bonella F, et al. Mechanisms of progressive fibrosis in connective tissue disease (CTD)- associated interstitial lung diseases (ILDs). Ann Rheum Dis. 2021;80(2):143–50.Brito-Zerón P, Kostov B, Solans R, Fraile G, Suárez-Cuervo C, Casanovas A, et al. Systemic activity and mortality in primary Sjögren syndrome: Predicting survival using the EULAR-SS Disease Activity Index (ESSDAI) in 1045 patients. Ann Rheum Dis. 2016;75(2):348–55.Maqhuzu PN, Szentes BL, Kreuter M, Bahmer T, Kahn N, Claussen M, et al. Determinants of health-related quality of life decline in interstitial lung disease. Health Qual Life Outcomes. 2020 Oct 8;18(1).Ley B, Collard HR. Epidemiology of idiopathic pulmonary fibrosis. Vol. 5, Clinical Epidemiology. 2013. p. 483–92.Zheng Q, Cox IA, Campbell JA, Xia Q, Otahal P, de Graaff B, et al. Mortality and survival in idiopathic pulmonary fibrosis: a systematic review and meta-analysis. Vol. 8, ERJ Open Research. European Respiratory Society; 2022Fischer A, Antoniou KM, Brown KK, Cadranel J, Corte TJ, Du Bois RM, et al. An official European Respiratory Society/American Thoracic Society research statement: Interstitial pneumonia with autoimmune features. In: European Respiratory Journal. European Respiratory Society; 2015. p. 976–87.Wijsenbeek M, Kreuter M, Olson A, Fischer A, Bendstrup E, Wells CD, et al. Progressive fibrosing interstitial lung diseases: current practice in diagnosis and management. Curr Med Res Opin. 2019 Nov 2;35(11):2015–24.He C, Chen Z, Liu S, Chen H, Zhang F. Prevalence and risk factors of interstitial lung disease in patients with primary Sjögren’s syndrome: A systematic review and meta-analysis. Vol. 23, International Journal of Rheumatic Diseases. Blackwell Publishing; 2020. p. 1009–18.Xu Y, Zhou J, Dong X, Guo X, Lu Y, Zheng Y. Risk factors for progression and prognosis of primary Sjögren’s syndrome-associated interstitial lung disease in a Chinese population. Int J Rheum Dis. 2020 Dec 1;23(12):1734–40.Richeldi L, Ryerson CJ, Lee JS, Wolters PJ, Koth LL, Ley B, et al. Relative versus absolute change in forced vital capacity in idiopathic pulmonary fibrosis. Thorax. 2012;67(5):407–11.Fayyaz A, Kurien BT, Scofield RH. Autoantibodies in Sjögren’s Syndrome. Rheum Dis Clin North Am. 2016 Aug 1;42(3):419–34.Anaya JM, Talal N. Sjögren’s Syndrome Comes of Age. Semin Arthritis Rheum. 1999;28(6):355–9.Moutsopoulos HM. Sjögren´s Syndrome autoimmune epithelitis. Clinical Immunology and Inmmunopathology. 1994;72(2):162–5.Goules A V., Tzioufas AG. Primary Sjögren’s syndrome: Clinical phenotypes, outcome and the development of biomarkers. Vol. 15, Autoimmunity Reviews. Elsevier B.V.; 2016. p. 695–703.Qin B, Wang J, Yang Z, Yang M, Ma N, Huang F, et al. Epidemiology of primary Sjögren’s syndrome: A systematic review and meta-analysis. Vol. 74, Annals of the Rheumatic Diseases. BMJ Publishing Group; 2015. p. 1983–9.Restrepo-Jiménez P, Molano-González N, Anaya JM. Geoepidemiology of Sjögren’s syndrome in Latin America. Joint Bone Spine. 2019 Oct 1;86(5):620– 6.Shiboski CH, Shiboski SC, Seror R, Criswell LA, Labetoulle M, Lietman TM, et al. 2016 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Primary Sjögren’s Syndrome: A Consensus and Data-Driven Methodology Involving Three International Patient Cohorts. Arthritis and Rheumatology. 2017 Jan 1;69(1):35–45.Fisher BA, Jonsson R, Daniels T, Bombardieri M, Brown RM, Morgan P, et al. Standardisation of labial salivary gland histopathology in clinical trials in primary Sjögren’s syndrome. Ann Rheum Dis. 2017 Jul 1;76(7):1161–8.Travis WD, Costabel U, Hansell DM, King TE, Lynch DA, Nicholson AG, et al. An official American Thoracic Society/European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2013 Sep 15;188(6):733–48.Raghu G, Chen SY, Hou Q, Yeh WS, Collard HR. 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