REVUE ALGERIENNE D’ALLERGOLOGIE
Volume 10, Numéro 2, Pages 27-35
2026-01-05

Demographic, Clinical, And Laboratory Features Of Patients With Seronegative Primary Sjögren’s Syndrome In Western Algeria



Authors : Mehadji Nafissa . Bouali-youcef Youcef . Ouiekhlef Nardjess . Yahiaoui Meryem . Achouri Djahida . Guerbato Farah .

Abstract

Introduction: To investigate the clinical and immune features of patients with primary Sjögren’s syndrome (pSS) negative for auto antibodies: anti-SSA/Ro, anti-SSB/La, Anti-Nuclear Antibodies (ANA) and Rheumatic Factor (RF) in a population of Western Algeria. Studied population and Methods: 65 patients with pSS in western Algeria were retrospectively examined between 2021 and 2023. Patients with negative anti SSA/Ro, anti SSB/La, ANA, and RF antibodies comprised the seronegative group, while patients with at least one positive antibody were included in the seropositive group. Clinical manifestations, laboratory and histopathological findings were compared between the two groups. Results: Among the 65 patients with pSS, 16 (24.6%) were seronegative. The most common clinical manifestations in the seronegative patient group are: xerostomia (87.5%), xerophthalmia (81.3%) and joint involvement (68.8%). All of these patients have positive salivary gland biopsies showing a focus score ≥1 (100%). Compared to seropositive pSS, seronegative pSS has a low proportion of female gender (p= 0.029). Among clinical manifestations, Endocrine involvement and Association with a specific auto immune disease exhibited a lower prevalence within the seronegative group (p= 0.006 and p = 0.014 respectively). Among biological and immunological characteristics, elevated sedimentation rate was more frequent in seronegative group (p=0.03) while hypergammaglobulinemia was more frequent in seropositive group (p=0.025). Conclusion: The seronegative pSS is distinct from seropositive pSS, indicating possible different underlying pathogenesis mechanisms. The absence of conventional serologic markers may reflect limitations in current tools, rather than true immunological silence. Novel (not part of diagnostic criteria) antibodies may play a role in identifying this group of pSS patients.

Keywords

Primary Sjogren’s syndrome ; Seronegative ; Autoimmune thyroiditis ; Hypergammaglobulinemia ; Erythrocyte Sedimentation Rate ; Minor salivary gland biopsy

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