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Diagnosis of Sjogren's Syndrome

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Overview
Antibodies
Biomarkers
Nailfold Capillaroscopy
Salivary Gland Biopsy
Schirmer's Test
Slit Lamp Test
Ultrasonography of Glands

Overview

Typical diagnostic tests for Sjogren's include Schirmer's eye test, slit-lamp test, tests measuring saliva flow, radiologic salivary scans, and salivary gland biopsy.

Prevalence of distal renal tubular acidosis in primary Sjögren's syndrome (pSS). Furosemide and fludrocortisone (FF) cannot replace NH4Cl in testing urinary acidification in pSS, but may be considered as a screening tool. PubMed, Rheumatology (Oxford), 2014 Oct 29.

Antibodies

New study to investigate how good antibodies go bad. New research aims to re–examine whether IgM, a seemingly harmless antibody, is pathogenic, or capable of causing disease. University at Buffalo News Center, 01/13/2016.

Antibodies to interferon-inducible protein-16 in primary Sjögren's syndrome are associated with markers of more severe disease. Anti-IFI16 antibodies are a prominent specificity in primary SS and are associated with markers of severe disease. PubMed, Arthritis Care Res (Hoboken), 06/02/2015.

The Prevalence Of Autoantibodies Prior To Diagnosis In Patients With Primary Sjögren's Syndrome. The classical pSS autoantibodies can be detected years before symptom onset and diagnosis. E. Theander. EULAR 2011 OPO071. Ann Rheum Dis 2011;70 (Suppl3):91.

Anti-centromere antibody-seropositive Sjögren's syndrome (SS) differs from conventional subgroup in clinical and pathological study. Low cellular infiltration but with an increase in fibrous tissues may explain the clinical feature of a high prevalence of Raynaud's phenomenon (RP) and normal IgG concentration in ACA+ primary SS. Hideki Nakamura. BMC Musculoskelet Disord, 2010; 11: 140.

Biomarker

High fidelity between saliva proteomics and the salivary glands' biological state defines biomarker-signatures for primary Sjögren's syndrome (SS). The SS-related molecular landscape conveyed by saliva showed great congruence with histopathology features evoked by SS and advances understanding of this disease at a molecular level. PubMed, Arthritis Rheumatol, 12/29/2014.

Establishment of a novel diagnostic model for Sjögren's syndrome (pSS) by proteomic fingerprinting. Proteomic fingerprinting was able to distinguish pSS from non-pSS controls with a sensitivity of 77.1 % and a specificity of 85.5 %, and was effective in the diagnosis of pSS. PubMed, Clin Rheumatol, 2014 Sep 2.

Nailfold Capillaroscopy

Nailfold capillaroscopic findings in primary Sjögren's syndrome with and without Raynaud's phenomenon and/or positive anti-SSA/Ro and anti-SSB/La antibodies. Patients with RP associated with PSS had more dilated capillaries, but neither pericapillary haemorrhages nor capillary thrombosis was observed. PubMed, Rheumatol Int, 11/23/2015. (Also see Diagnosis of Primary Raynaud's using Nailfold Capillaroscopy)

Salivary Gland Biopsy

Neurological adverse events related to lip biopsy in patients suspicious for Sjogren's syndrome (SS). The minimally invasive lip biopsy technique for SS diagnosis induces fewer permanent neurological complications than conventional approaches. PubMed, Rheumatology, 2014 Mar 4.

Schirmer's Test for Diagnosis of Sjogren's Syndrome

Schirmer's Test. This is also known as a dry eye test, a tear test, or a tearing test. The Schirmer's test determines whether the eye produces enough tears to keep it moist. Paper strips are inserted under the eyelid. Before the test, you may be given numbing eye drops to prevent tearing due to the irritation from the paper. Most often, the eyes are closed for about 5 minutes. Medline Plus, NIH.

Slit Lamp Test

Slit Lamp Examination. The slit lamp exam uses an instrument that provides a magnified, three-dimensional (3-D) view of the different parts of the eye. During the exam, your health professional can look at the front parts of the eye, including the clear, outer covering (cornea), the lens, the colored part (iris), and the front section of the gel-like fluid (vitreous gel) that fills the large space in the middle of the eye. WebMD.

Ultrasonography of Glands

Diagnostic properties of ultrasound of major salivary glands in Sjögren's Syndrome: a meta-analysis. The quality of current studies is low, thus not allowing to judge the likelihood of salivary gland ultrasonography as a reliable and practical tool in diagnosing Sjögren's Syndrome. PubMed, Oral Dis, 05/18/2015.

Salivary Gland Ultrasonography (US) as a Diagnostic Tool for Secondary Sjögren Syndrome (sSS) in Rheumatoid Arthritis (RA). Salivary gland US may aid the diagnosis of sSS in patients with RA. PubMed, J Rheumatol, 05/01/2015. (Also see Rheumatoid Arthritis in Overlap)

The role of salivary gland elastosonography in Sjogren's syndrome (SS): preliminary results. With the progression of Sjogren's, the elasticity scores of the parotid glands increase gradually, indicating that ultrasonic elastosonography has the potential to demonstrate the progression of the disease. PubMed, Int J Rheum Dis, 2014 Sep 15.

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