Reviewer's report
 The liver is a common extra-glandular target in primary Sjogren's syndrome: A retrospective Title:
review
Authors:
Mariana J Kaplan (makaplan@umich.edu )
Robert W Ike (rike@umich.edu )
 1  18 Jun 2002 Version: Date:
 Prof David Kershenobich Reviewer:
 A paper of considerable general medical or scientific interest Level of interest:
 Unable to decide on acceptance or rejection until the authors have responded Advice on publication:
to the compulsory revisions
This is an interesting work that addresses a topic which is 
frequently forgotten by clinicians. There are however several issues 
which the authors should clarify that would help to better 
understand the liver involvement in primary Sjogren's syndrome. 
1.- The criteria of liver disfunction that the authors use are not 
clearly defined in the manuscript , they need to be indicated in the 
text. 
2.- Similarly , a statement must be made as to what criteria do 
the authors consider to define the abormalities of liver function as persistent or intermittent. 
3.- The authors state that the prevalence of liver disfunction (criteria 
to be defined) in patients with primary SS. is 49.1 %, however the real figure may be 40 % as the 14 cases without liver function test 
probably did not have overt clinical liver disease. 
4.- What is the percentage of association of hepatic disease with 
other systemic features and autoimmunity of primary SS ? 
5.- It would be of interest if the authors could be more specific in 
time when they say that in all cases the diagnosis of primary SS. antedated the onset of liver disease or its diagnosis, in particular 
as many of the patients where receiving drugs that by itself may be 
hepatotoxic and responsible of some of the laboratory abnormalities. The issue of drug toxicity is not addressed in the discussion, I think that it is very relevant that his issue surface in 
the discussion.
Competing interests:
None declared.
Reviewer's report
 The liver is a common extra-glandular target in primary Sjogren's syndrome: A retrospective Title:
review
Authors:
Mariana J Kaplan (makaplan@umich.edu )
Robert W Ike (rike@umich.edu )
 1  18 Jun 2002 Version: Date:
 Prof David Kershenobich Reviewer:
 A paper of considerable general medical or scientific interest Level of interest:
 Unable to decide on acceptance or rejection until the authors have responded Advice on publication:
to the compulsory revisions
This is an interesting work that addresses a topic which is 
frequently forgotten by clinicians. There are however several issues 
which the authors should clarify that would help to better 
understand the liver involvement in primary Sjogren's syndrome. 
1.- The criteria of liver disfunction that the authors use are not 
clearly defined in the manuscript , they need to be indicated in the 
text. 
2.- Similarly , a statement must be made as to what criteria do 
the authors consider to define the abormalities of liver function as persistent or intermittent. 
3.- The authors state that the prevalence of liver disfunction (criteria 
to be defined) in patients with primary SS. is 49.1 %, however the real figure may be 40 % as the 14 cases without liver function test 
probably did not have overt clinical liver disease. 
4.- What is the percentage of association of hepatic disease with 
other systemic features and autoimmunity of primary SS ? 
5.- It would be of interest if the authors could be more specific in 
time when they say that in all cases the diagnosis of primary SS. antedated the onset of liver disease or its diagnosis, in particular 
as many of the patients where receiving drugs that by itself may be 
hepatotoxic and responsible of some of the laboratory abnormalities. The issue of drug toxicity is not addressed in the discussion, I think that it is very relevant that his issue surface in 
the discussion.
Competing interests:
None declared.
Please review this paper.
user
Reviewer's report
 The liver is a common extra-glandular target in primary Sjogren's syndrome: A retrospective Title:
review
Authors:
Mariana J Kaplan (makaplan@umich.edu )
Robert W Ike (rike@umich.edu )
 1  18 Jun 2002 Version: Date:
 Prof David Kershenobich Reviewer:
 A paper of considerable general medical or scientific interest Level of interest:
 Unable to decide on acceptance or rejection until the authors have responded Advice on publication:
to the compulsory revisions
This is an interesting work that addresses a topic which is 
frequently forgotten by clinicians. There are however several issues 
which the authors should clarify that would help to better 
understand the liver involvement in primary Sjogren's syndrome. 
1.- The criteria of liver disfunction that the authors use are not 
clearly defined in the manuscript , they need to be indicated in the 
text. 
2.- Similarly , a statement must be made as to what criteria do 
the authors consider to define the abormalities of liver function as persistent or intermittent. 
3.- The authors state that the prevalence of liver disfunction (criteria 
to be defined) in patients with primary SS. is 49.1 %, however the real figure may be 40 % as the 14 cases without liver function test 
probably did not have overt clinical liver disease. 
4.- What is the percentage of association of hepatic disease with 
other systemic features and autoimmunity of primary SS ? 
5.- It would be of interest if the authors could be more specific in 
time when they say that in all cases the diagnosis of primary SS. antedated the onset of liver disease or its diagnosis, in particular 
as many of the patients where receiving drugs that by itself may be 
hepatotoxic and responsible of some of the laboratory abnormalities. The issue of drug toxicity is not addressed in the discussion, I think that it is very relevant that his issue surface in 
the discussion.
Competing interests:
None declared.
assistant