Clinical and serologic features of sicca syndrome in a tertiary care cohort in China: a retrospective rheumatologic study

Background Sicca syndrome is a clinical syndrome with heterogeneous pathogenesis defined by chronic ocular and/or oral dryness resulting from autoimmune disorders, medications, ageing or other systemic disorders. The clinical and serologic spectrum must be clearly defined to enable accurate diagnostic assessment and clinical characterization. Objective To assess the clinical and serologic characteristics of patients with sicca syndrome and identify factors associated with extraglandular manifestations. Methodology A retrospective observational study of 765 adults with sicca syndrome who were treated at a tertiary care rheumatology centre in China from January 2023 to December 2025. Information was retrieved from the electronic medical record, which included demographic, clinical, laboratory, and autoantibody data. Data analysis was performed using SPSS version 29.0, with comparative analysis, correlation tests, multivariable logistic regression and sensitivity analysis of the regression model. Results The average age was 52.8 ± 13.6 years and 86.7% of patients were female. 70% of patients had both ocular and oral dryness, and 59.1% had at least one extraglandular manifestation. ANA, anti-SSA/Ro, anti-SSB/La and rheumatoid factor were positive in 74.6%, 61.2%, 36.1% and 44.7% of patients, respectively. Patients who were anti-SSA positive had significantly more systemic involvement, compared to those who were anti-SSA negative (65.2% vs. 49.5%, P < 0.001). Conclusion The findings of this tertiary-care cohort were dominated by middle-aged women with sicca syndrome, and there was significant clinical and serologic variability. Anti-SSA antibodies, hypergammaglobulinemia, increased inflammatory markers and complement consumption were associated with systemic manifestations. Anti-SSA/Ro positivity may be a marker of a distinct serological and potentially systemic phenotype; however, given the observational design, these findings reflect associations rather than causal relationships and may inform, rather than determine, the clinical assessment of patients with sicca syndrome.