Disease phenotype and diagnostic delay in Saudi patients with primary Sjogren's syndrome An exploratory cross-sectional study

Objectives: To describe primary Sjogren's syndrome (pSS) cohort in Saudi Arabiain view in of clinical/serological/histopathological phentotype, and, diagnostic delay. Methods: A cross-sectional study conducted between October 2018 and May 2019. Diagnostic delay was calculated from symptoms onset to clinical diagnosis. The European League Against Rheumatism (EULAR) Sjogren's Syndrome Disease Activity Index (ESSDAI) and EULAR Sjogren's Syndrome Patient Reported Index (ESSPRI) were calculated. Results: Forty-one patients were included in the study. There were predominantly females (78%) with a mean (+/- SD) age of 58.76 +/- 12.7 and disease duration of 4.6 +/- 2.28 years. The mean diagnostic delay was 2.2 +/- 2.4 (range 1-11) years. Minor salivary gland biopsy was performed on 38 (92.7%) patients with a mean focus score of 2.3 +/- 1.2 points. Interstitial lung disease and arthritis were the most common extra-glandular manifestations (EGM) affecting 27 (65.9%) patients for both. The mean ESSDAI was 9.95 +/- 7.73 and ESSPRI was 5.17 +/- 2.4. Conclusion: Saudi primary Sjogren's syndrome patients have a high prevalence of EGM predominantly arthritis and ILD. The diagnostic delay is variable in our cohort.