Sjögren's syndrome differential diagnosis: Difference between revisions

Jump to navigation Jump to search
m (Template)
Line 8: Line 8:


==Differential Diagnosis==
==Differential Diagnosis==
===== Differentiating Sjögren's syndrome from other diseases that may cause [[arthritis]] and [[rash]]=====
<span style="font-size:85%">'''Abbreviations:'''
'''ANA:''' [[Anti-nuclear antibody|Antinuclear antibody]], '''RF:''' [[Rheumatoid factor]], '''Anti-CCp:''' [[Anti-citrullinated protein antibody|Anti-cyclic citrullinated protein antibody]], '''Anti U1RNP:''' Anti-U1 ribonucleoprotein antibodies , '''Anti Sm :''' Anti-Sm antibodies, '''Anti Ro:''' Anti Ro antibody also called anti-Sjögren's-syndrome-related antigen A antibody, '''Anti-dsDNA:''' [[Anti-dsDNA antbodies|Anti-double stranded DNA]].
</span>
<br>
<small>
{| class="wikitable"
! colspan="2" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Disease
! colspan="5" align="center" style="background:#4479BA; color: #FFFFFF;" |Arthritis
! colspan="7" align="center" style="background:#4479BA; color: #FFFFFF;" |Auto-antibodies
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Raynaud phenomenon
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Rash pattern
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Distinguishing/specific features
|-
! align="center" style="background:#4479BA; color: #FFFFFF;" |Polyarthritis
! align="center" style="background:#4479BA; color: #FFFFFF;" |Tenderness
! align="center" style="background:#4479BA; color: #FFFFFF;" |Edema
! align="center" style="background:#4479BA; color: #FFFFFF;" |Deformity /Erosion
! align="center" style="background:#4479BA; color: #FFFFFF;" |Pattern
! align="center" style="background:#4479BA; color: #FFFFFF;" |ANA
! align="center" style="background:#4479BA; color: #FFFFFF;" |RF
! align="center" style="background:#4479BA; color: #FFFFFF;" |Anti-CCp
! align="center" style="background:#4479BA; color: #FFFFFF;" |Anti U1RNP
! align="center" style="background:#4479BA; color: #FFFFFF;" |Anti Sm
! align="center" style="background:#4479BA; color: #FFFFFF;" |Anti Ro
! align="center" style="background:#4479BA; color: #FFFFFF;" |Anti-dsDNA
|-
| colspan="2" align="center" style="background:#DCDCDC;" |[[Systemic lupus erythematosus]]<ref name="pmid25074031">{{cite journal |vauthors=Ehmke TA, Cherian JJ, Wu ES, Jauregui JJ, Banerjee S, Mont MA |title=Treatment of osteonecrosis in systemic lupus erythematosus: a review |journal=Curr Rheumatol Rep |volume=16 |issue=9 |pages=441 |year=2014 |pmid=25074031 |doi=10.1007/s11926-014-0441-8 |url=}}</ref>
| align="center" |<nowiki>+</nowiki>
| align="center" |<nowiki>+</nowiki>
| align="center" |<nowiki>+</nowiki>
| align="center" |<nowiki>-</nowiki>
| align="center" |Small joints
| align="center" |↑
| align="center" |<nowiki>-</nowiki>
| align="center" |<nowiki>-</nowiki>
| align="center" | -
| align="center" |↑
| align="center" |↑
| align="center" | -
| align="center" |<nowiki>+</nowiki>
|[[Malar rash]] and [[photosensitivity]]
|
|-
| colspan="2" align="center" style="background:#DCDCDC;" |[[Rheumatoid arthritis]]  ([[Rheumatoid arthritis|RA]])<ref name="pmid11567728">{{cite journal |vauthors=Lee DM, Weinblatt ME |title=Rheumatoid arthritis |journal=Lancet |volume=358 |issue=9285 |pages=903–11 |year=2001 |pmid=11567728 |doi=10.1016/S0140-6736(01)06075-5 |url=}}</ref>
| align="center" | +
| align="center" | +
| align="center" | +
| align="center" | +
| align="center" |Small and large joints
| align="center" |<nowiki>-</nowiki>
| align="center" |↑↑
| align="center" |↑↑
| align="center" |<nowiki>-</nowiki>
| align="center" |<nowiki>-</nowiki>
| align="center" | -
| align="center" | -
| align="center" | +
|[[Subcutaneous]] [[nodules]]
|Erosive [[arthropathy]]
|-
| colspan="2" align="center" style="background:#DCDCDC;" |Rhupus<ref name="pmid3382309">{{cite journal |vauthors=Panush RS, Edwards NL, Longley S, Webster E |title='Rhupus' syndrome |journal=Arch. Intern. Med. |volume=148 |issue=7 |pages=1633–6 |year=1988 |pmid=3382309 |doi= |url=}}</ref>
| align="center" | +
| align="center" | +
| align="center" | +
| align="center" | +
| align="center" |Small and large joints
| align="center" |↑
| align="center" |↑
| align="center" |↑
| align="center" |↑
| align="center" |↑
| align="center" |<nowiki>-</nowiki>
| align="center" |↑
| align="center" | +
|[[Malar rash]] and [[photosensitivity]]
|Erosive [[arthropathy]]
|-
| colspan="2" align="center" style="background:#DCDCDC;" |[[Mixed connective tissue disease]] (MCTD)<ref name="pmid21959290">{{cite journal |vauthors=Cappelli S, Bellando Randone S, Martinović D, Tamas MM, Pasalić K, Allanore Y, Mosca M, Talarico R, Opris D, Kiss CG, Tausche AK, Cardarelli S, Riccieri V, Koneva O, Cuomo G, Becker MO, Sulli A, Guiducci S, Radić M, Bombardieri S, Aringer M, Cozzi F, Valesini G, Ananyeva L, Valentini G, Riemekasten G, Cutolo M, Ionescu R, Czirják L, Damjanov N, Rednic S, Matucci Cerinic M |title="To be or not to be," ten years after: evidence for mixed connective tissue disease as a distinct entity |journal=Semin. Arthritis Rheum. |volume=41 |issue=4 |pages=589–98 |year=2012 |pmid=21959290 |doi=10.1016/j.semarthrit.2011.07.010 |url=}}</ref>
| align="center" |<nowiki>-</nowiki>
| align="center" | -
| align="center" | -
| align="center" | +
| align="center" |Small and large joints
| align="center" |<nowiki>-</nowiki>
| align="center" |↑↑
| align="center" |↑
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | +
|Cutaneous eruptions, [[Gottron's papules|gottron’s papules]], photodistributed [[erythema]], [[Poikiloderma of civatte|poikiloderma]], and [[calcinosis cutis]]
|Overlapping features of SLE, [[systemic sclerosis]] (SSc), and [[polymyositis]] (PM) that lead to more than one diagnosis
|-
| colspan="2" align="center" style="background:#DCDCDC;" |[[Undifferentiated connective tissue disease]] (UCTD)<ref name="pmid1757934">{{cite journal |vauthors=Alarcón GS, Williams GV, Singer JZ, Steen VD, Clegg DO, Paulus HE, Billingsley LM, Luggen ME, Polisson RP, Willkens RF |title=Early undifferentiated connective tissue disease. I. Early clinical manifestation in a large cohort of patients with undifferentiated connective tissue diseases compared with cohorts of well established connective tissue disease |journal=J. Rheumatol. |volume=18 |issue=9 |pages=1332–9 |year=1991 |pmid=1757934 |doi= |url=}}</ref>
| align="center" | +
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" |Lower extremity
| align="center" |↑
| align="center" |↑
| align="center" | -
| align="center" | -
| align="center" |↑
| align="center" | -
| align="center" | -
| align="center" | +
|[[Erythematous]] [[macules]], patches, or [[papules]] with delicate scale
|Multiple connective tissue diseases with no enough criteria for a single diagnosis
|-
| colspan="2" align="center" style="background:#DCDCDC;" |[[Systemic sclerosis]] (SSc)<ref name="pmid3361530">{{cite journal |vauthors=LeRoy EC, Black C, Fleischmajer R, Jablonska S, Krieg T, Medsger TA, Rowell N, Wollheim F |title=Scleroderma (systemic sclerosis): classification, subsets and pathogenesis |journal=J. Rheumatol. |volume=15 |issue=2 |pages=202–5 |year=1988 |pmid=3361530 |doi= |url=}}</ref>
| align="center" |<nowiki>+/-</nowiki>
| align="center" |<nowiki>+</nowiki>
| align="center" |<nowiki>+</nowiki>
| align="center" |<nowiki>+/-</nowiki>
| align="center" |Lower extremity
| align="center" |↑↑
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" |↑
| align="center" | -
| align="center" |↑
| align="center" | +
|[[Hyperkeratosis]], [[edema]], and [[erythema]]
|[[Sclerodactyly]], [[Telangiectasias]], [[Calcinosis]], [[Malignant hypertension]], [[acute renal failure]]
|-
| colspan="2" align="center" style="background:#DCDCDC;" |[[Sjögren’s syndrome]]<ref name="pmid15485020">{{cite journal |vauthors=Roguedas AM, Misery L, Sassolas B, Le Masson G, Pennec YL, Youinou P |title=Cutaneous manifestations of primary Sjögren's syndrome are underestimated |journal=Clin. Exp. Rheumatol. |volume=22 |issue=5 |pages=632–6 |year=2004 |pmid=15485020 |doi= |url=}}</ref>
| align="center" |<nowiki>+/-</nowiki>
| align="center" |<nowiki>+/-</nowiki>
| align="center" | -
| align="center" | -
| align="center" |[[Lower extremity]], axiallary creases
| align="center" |↑
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" |↑
| align="center" |↑
| align="center" | -
| align="center" | -
|[[Xerosis]], scaly skin, annular [[erythema]]
|[[Keratoconjunctivitis sicca]]
|-
| rowspan="3" align="center" style="background:#DCDCDC;" |Vasculitis
| align="center" style="background:#DCDCDC;" |[[Giant cell]]<ref name="pmid17031245">{{cite journal |vauthors=Bablekos GD, Michaelides SA, Karachalios GN, Nicolaou IN, Batistatou AK, Charalabopoulos KA |title=Pericardial involvement as an atypical manifestation of giant cell arteritis: report of a clinical case and literature review |journal=Am. J. Med. Sci. |volume=332 |issue=4 |pages=198–204 |year=2006 |pmid=17031245 |doi= |url=}}</ref>
| align="center" | -
| align="center" |<nowiki>+</nowiki>
| align="center" |<nowiki>+</nowiki>
| align="center" | -
| align="center" |Distal extremity
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| rowspan="3" align="center" | -
|Rare
|Involvement of cranial branches of arteries, visual loss
|-
| align="center" style="background:#DCDCDC;" |[[Takayasu's arteritis|Takayasu]]<ref name="pmid12655">{{cite journal |vauthors=Lupi-Herrera E, Sánchez-Torres G, Marcushamer J, Mispireta J, Horwitz S, Vela JE |title=Takayasu's arteritis. Clinical study of 107 cases |journal=Am. Heart J. |volume=93 |issue=1 |pages=94–103 |year=1977 |pmid=12655 |doi= |url=}}</ref>
| align="center" |<nowiki>-</nowiki>
| align="center" | +/-
| align="center" | +/-
| align="center" | -
| align="center" |Transient extremity
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
|[[Erythema nodosum]], [[pyoderma gangrenosum]]
|Absent or weak peripheral pulse
|-
| align="center" style="background:#DCDCDC;" |[[Polyarteritis nodosa|Poly-arteritis nodosa]]<ref name="pmid20112401">{{cite journal |vauthors=Pagnoux C, Seror R, Henegar C, Mahr A, Cohen P, Le Guern V, Bienvenu B, Mouthon L, Guillevin L |title=Clinical features and outcomes in 348 patients with polyarteritis nodosa: a systematic retrospective study of patients diagnosed between 1963 and 2005 and entered into the French Vasculitis Study Group Database |journal=Arthritis Rheum. |volume=62 |issue=2 |pages=616–26 |year=2010 |pmid=20112401 |doi=10.1002/art.27240 |url=}}</ref>
| align="center" | -
| align="center" | +/-
| align="center" | -
| align="center" | -
| align="center" |General and mild
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
|[[Tenderness|Tender]] [[Erythematous rash|erythematous nodules]], [[purpura]], [[livedo reticularis]], [[bullous]] or [[Vesicular|vesicular eruption]]
|[[Testicular pain]] or [[tenderness]] and [[neuropathies]]
|-
| colspan="2" align="center" style="background:#DCDCDC;" |[[Behçet's Syndrome|Behçet’s syndrome]]<ref name="pmid11760398">{{cite journal |vauthors=Tunç R, Uluhan A, Melikoğlu M, Ozyazgan Y, Ozdoğan H, Yazici H |title=A reassessment of the International Study Group criteria for the diagnosis (classification) of Behçet's syndrome |journal=Clin. Exp. Rheumatol. |volume=19 |issue=5 Suppl 24 |pages=S45–7 |year=2001 |pmid=11760398 |doi= |url=}}</ref>
| align="center" |<nowiki>+/-</nowiki>
| align="center" |<nowiki>+/-</nowiki>
| align="center" |<nowiki>+/-</nowiki>
| align="center" | -
| align="center" |medium and large joints
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
|Recurrent and usually painful [[mucocutaneous]] ulcers, [[Acneiform eruption|acneiform]] [[lesions]], papulo-vesiculo-[[Pustular rash|pustular]] eruptions, superficial [[thrombophlebitis]]
|Male dominancy
|-
| colspan="2" align="center" style="background:#DCDCDC;" |[[Kikuchi's Disease|Kikuchi’s disease]]<ref name="pmid16538388">{{cite journal |vauthors=Kucukardali Y, Solmazgul E, Kunter E, Oncul O, Yildirim S, Kaplan M |title=Kikuchi-Fujimoto Disease: analysis of 244 cases |journal=Clin. Rheumatol. |volume=26 |issue=1 |pages=50–4 |year=2007 |pmid=16538388 |doi=10.1007/s10067-006-0230-5 |url=}}</ref>
| align="center" | -
| align="center" |<nowiki>+/-</nowiki>
| align="center" | -
| align="center" | -
| align="center" |medium and large joints
| align="center" |↑/↓
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
|Transient skin [[rashes]], [[malar rash]], [[Macule|erythematous macules]], patches, [[papules]], or [[plaques]]
|May be associated with SLE
|-
| colspan="2" align="center" style="background:#DCDCDC;" |[[Serum sickness]]<ref name="pmid3564980">{{cite journal |vauthors=Kunnamo I, Kallio P, Pelkonen P, Viander M |title=Serum-sickness-like disease is a common cause of acute arthritis in children |journal=Acta Paediatr Scand |volume=75 |issue=6 |pages=964–9 |year=1986 |pmid=3564980 |doi= |url=}}</ref>
| align="center" | +
| align="center" |<nowiki>+</nowiki>
| align="center" |<nowiki>+/-</nowiki>
| align="center" | -
| align="center" |General
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
|[[Pruritic disorders|Pruritic rash]], [[urticaria]] and/or serpiginous [[Rash|macular rash]]
|Self-limited
|-
| colspan="2" align="center" style="background:#DCDCDC;" |[[Psoriatic arthritis]]<ref name="pmid8076388">{{cite journal |vauthors=Oriente P, Biondi-Oriente C, Scarpa R |title=Psoriatic arthritis. Clinical manifestations |journal=Baillieres Clin Rheumatol |volume=8 |issue=2 |pages=277–94 |year=1994 |pmid=8076388 |doi= |url=}}</ref>
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" |Small and large joints
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
|[[Psoriasis]] and [[onychodystrophy]]
|[[Dactylitis]] (sausage digits)
|-
| colspan="2" align="center" style="background:#DCDCDC;" |[[Parvovirus B19|Human parvovirus B19 infection]]<ref name="pmid17384979">{{cite journal |vauthors=Kaufmann J, Buccola JM, Stead W, Rowley C, Wong M, Bates CK |title=Secondary symptomatic parvovirus B19 infection in a healthy adult |journal=J Gen Intern Med |volume=22 |issue=6 |pages=877–8 |year=2007 |pmid=17384979 |pmc=2219874 |doi=10.1007/s11606-007-0173-9 |url=}}</ref>
| align="center" |<nowiki>+</nowiki>
| align="center" |<nowiki>+</nowiki>
| align="center" | -
| align="center" | -
| align="center" |Small joints
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
| align="center" | -
|[[Erythematous rash|Erythematous rashes]]
|Rare in adults, [[Fifth disease|fifth's disease]] in children
|}</small>


==References==
==References==

Revision as of 21:18, 1 August 2017

Sjögren's syndrome Microchapters

Home

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Sjögren's syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

Echocardiography and Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Sjögren's syndrome differential diagnosis On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Sjögren's syndrome differential diagnosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Sjögren's syndrome differential diagnosis

CDC on Sjögren's syndrome differential diagnosis

Sjögren's syndrome differential diagnosis in the news

Blogs on Sjögren's syndrome differential diagnosis

Directions to Hospitals Treating Sjögren's syndrome

Risk calculators and risk factors for Sjögren's syndrome differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Please help WikiDoc by adding content here. It's easy! Click here to learn about editing.

Overview

Differential Diagnosis

Differentiating Sjögren's syndrome from other diseases that may cause arthritis and rash

Abbreviations: ANA: Antinuclear antibody, RF: Rheumatoid factor, Anti-CCp: Anti-cyclic citrullinated protein antibody, Anti U1RNP: Anti-U1 ribonucleoprotein antibodies , Anti Sm : Anti-Sm antibodies, Anti Ro: Anti Ro antibody also called anti-Sjögren's-syndrome-related antigen A antibody, Anti-dsDNA: Anti-double stranded DNA.

Disease Arthritis Auto-antibodies Raynaud phenomenon Rash pattern Distinguishing/specific features
Polyarthritis Tenderness Edema Deformity /Erosion Pattern ANA RF Anti-CCp Anti U1RNP Anti Sm Anti Ro Anti-dsDNA
Systemic lupus erythematosus[1] + + + - Small joints - - - - + Malar rash and photosensitivity
Rheumatoid arthritis (RA)[2] + + + + Small and large joints - ↑↑ ↑↑ - - - - + Subcutaneous nodules Erosive arthropathy
Rhupus[3] + + + + Small and large joints - + Malar rash and photosensitivity Erosive arthropathy
Mixed connective tissue disease (MCTD)[4] - - - + Small and large joints - ↑↑ - - - - + Cutaneous eruptions, gottron’s papules, photodistributed erythema, poikiloderma, and calcinosis cutis Overlapping features of SLE, systemic sclerosis (SSc), and polymyositis (PM) that lead to more than one diagnosis
Undifferentiated connective tissue disease (UCTD)[5] + - - - Lower extremity - - - - + Erythematous macules, patches, or papules with delicate scale Multiple connective tissue diseases with no enough criteria for a single diagnosis
Systemic sclerosis (SSc)[6] +/- + + +/- Lower extremity ↑↑ - - - - + Hyperkeratosis, edema, and erythema Sclerodactyly, Telangiectasias, Calcinosis, Malignant hypertension, acute renal failure
Sjögren’s syndrome[7] +/- +/- - - Lower extremity, axiallary creases - - - - - Xerosis, scaly skin, annular erythema Keratoconjunctivitis sicca
Vasculitis Giant cell[8] - + + - Distal extremity - - - - - - - - Rare Involvement of cranial branches of arteries, visual loss
Takayasu[9] - +/- +/- - Transient extremity - - - - - - - Erythema nodosum, pyoderma gangrenosum Absent or weak peripheral pulse
Poly-arteritis nodosa[10] - +/- - - General and mild - - - - - - - Tender erythematous nodules, purpura, livedo reticularis, bullous or vesicular eruption Testicular pain or tenderness and neuropathies
Behçet’s syndrome[11] +/- +/- +/- - medium and large joints - - - - - - - - Recurrent and usually painful mucocutaneous ulcers, acneiform lesions, papulo-vesiculo-pustular eruptions, superficial thrombophlebitis Male dominancy
Kikuchi’s disease[12] - +/- - - medium and large joints ↑/↓ - - - - - - - Transient skin rashes, malar rash, erythematous macules, patches, papules, or plaques May be associated with SLE
Serum sickness[13] + + +/- - General - - - - - - - - Pruritic rash, urticaria and/or serpiginous macular rash Self-limited
Psoriatic arthritis[14] - - - - Small and large joints - - - - - - - - Psoriasis and onychodystrophy Dactylitis (sausage digits)
Human parvovirus B19 infection[15] + + - - Small joints - - - - - - - - Erythematous rashes Rare in adults, fifth's disease in children

References

  1. Ehmke TA, Cherian JJ, Wu ES, Jauregui JJ, Banerjee S, Mont MA (2014). "Treatment of osteonecrosis in systemic lupus erythematosus: a review". Curr Rheumatol Rep. 16 (9): 441. doi:10.1007/s11926-014-0441-8. PMID 25074031.
  2. Lee DM, Weinblatt ME (2001). "Rheumatoid arthritis". Lancet. 358 (9285): 903–11. doi:10.1016/S0140-6736(01)06075-5. PMID 11567728.
  3. Panush RS, Edwards NL, Longley S, Webster E (1988). "'Rhupus' syndrome". Arch. Intern. Med. 148 (7): 1633–6. PMID 3382309.
  4. Cappelli S, Bellando Randone S, Martinović D, Tamas MM, Pasalić K, Allanore Y, Mosca M, Talarico R, Opris D, Kiss CG, Tausche AK, Cardarelli S, Riccieri V, Koneva O, Cuomo G, Becker MO, Sulli A, Guiducci S, Radić M, Bombardieri S, Aringer M, Cozzi F, Valesini G, Ananyeva L, Valentini G, Riemekasten G, Cutolo M, Ionescu R, Czirják L, Damjanov N, Rednic S, Matucci Cerinic M (2012). ""To be or not to be," ten years after: evidence for mixed connective tissue disease as a distinct entity". Semin. Arthritis Rheum. 41 (4): 589–98. doi:10.1016/j.semarthrit.2011.07.010. PMID 21959290.
  5. Alarcón GS, Williams GV, Singer JZ, Steen VD, Clegg DO, Paulus HE, Billingsley LM, Luggen ME, Polisson RP, Willkens RF (1991). "Early undifferentiated connective tissue disease. I. Early clinical manifestation in a large cohort of patients with undifferentiated connective tissue diseases compared with cohorts of well established connective tissue disease". J. Rheumatol. 18 (9): 1332–9. PMID 1757934.
  6. LeRoy EC, Black C, Fleischmajer R, Jablonska S, Krieg T, Medsger TA, Rowell N, Wollheim F (1988). "Scleroderma (systemic sclerosis): classification, subsets and pathogenesis". J. Rheumatol. 15 (2): 202–5. PMID 3361530.
  7. Roguedas AM, Misery L, Sassolas B, Le Masson G, Pennec YL, Youinou P (2004). "Cutaneous manifestations of primary Sjögren's syndrome are underestimated". Clin. Exp. Rheumatol. 22 (5): 632–6. PMID 15485020.
  8. Bablekos GD, Michaelides SA, Karachalios GN, Nicolaou IN, Batistatou AK, Charalabopoulos KA (2006). "Pericardial involvement as an atypical manifestation of giant cell arteritis: report of a clinical case and literature review". Am. J. Med. Sci. 332 (4): 198–204. PMID 17031245.
  9. Lupi-Herrera E, Sánchez-Torres G, Marcushamer J, Mispireta J, Horwitz S, Vela JE (1977). "Takayasu's arteritis. Clinical study of 107 cases". Am. Heart J. 93 (1): 94–103. PMID 12655.
  10. Pagnoux C, Seror R, Henegar C, Mahr A, Cohen P, Le Guern V, Bienvenu B, Mouthon L, Guillevin L (2010). "Clinical features and outcomes in 348 patients with polyarteritis nodosa: a systematic retrospective study of patients diagnosed between 1963 and 2005 and entered into the French Vasculitis Study Group Database". Arthritis Rheum. 62 (2): 616–26. doi:10.1002/art.27240. PMID 20112401.
  11. Tunç R, Uluhan A, Melikoğlu M, Ozyazgan Y, Ozdoğan H, Yazici H (2001). "A reassessment of the International Study Group criteria for the diagnosis (classification) of Behçet's syndrome". Clin. Exp. Rheumatol. 19 (5 Suppl 24): S45–7. PMID 11760398.
  12. Kucukardali Y, Solmazgul E, Kunter E, Oncul O, Yildirim S, Kaplan M (2007). "Kikuchi-Fujimoto Disease: analysis of 244 cases". Clin. Rheumatol. 26 (1): 50–4. doi:10.1007/s10067-006-0230-5. PMID 16538388.
  13. Kunnamo I, Kallio P, Pelkonen P, Viander M (1986). "Serum-sickness-like disease is a common cause of acute arthritis in children". Acta Paediatr Scand. 75 (6): 964–9. PMID 3564980.
  14. Oriente P, Biondi-Oriente C, Scarpa R (1994). "Psoriatic arthritis. Clinical manifestations". Baillieres Clin Rheumatol. 8 (2): 277–94. PMID 8076388.
  15. Kaufmann J, Buccola JM, Stead W, Rowley C, Wong M, Bates CK (2007). "Secondary symptomatic parvovirus B19 infection in a healthy adult". J Gen Intern Med. 22 (6): 877–8. doi:10.1007/s11606-007-0173-9. PMC 2219874. PMID 17384979.

Template:WS Template:WH