Early diagnosis and treatment are important for preventing complications. The symptoms of Sjögren's syndrome may overlap with or “mimic” those of other diseases including lupus, rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome, and multiple sclerosis. Furthermore, dryness can occur for other reasons, such as a side effect of medication like anti-depressants or high blood pressure medication.

Additionally, because all symptoms are not always present at the same time and because Sjögren's can involve several body systems, physicians and dentists sometimes treat each symptom individually and do not recognize that a systemic disease is present. The average time from onset of symptoms to diagnosis is over six years. Rheumatologists have primary responsibility for diagnosing and managing Sjögren's syndrome.

Once Sjögren's syndrome is suspected, a physician will request a series of blood tests, including:

• ANA (Anti-Nuclear Antibody)
  ANAs are a group of antibodies that react against normal components of a cell nucleus. About 70% of Sjögren's patients have a positive ANA test result.



• SSA and SSB
  The antibodies SSA (or RO) and SSB (or LA) are often found in Sjögren's syndrome; 70% of patients are positive for SSA and 40% are positive for SSB.



• RF (Rheumatoid Factor)
  This antibody test is indicative of a rheumatic disease. In Sjögren's patients, 60-70% have a positive RF.



• ESR (Erythrocyte Sedimentation Rate)
  This test measures inflammation. An elevated ESR can indicate an inflammatory disorder, including Sjögren's syndrome.



• IGs (Immunoglobulins)
  These are normal blood proteins. They are usually elevated in Sjögren's.

The physician is likely to refer the patient to an ophthalmologist for further tests and to an oral pathologist or dentist for additional procedures.

The ophthalmologic tests include:

• Schirmer Test
  Measures tear production.



• Rose Bengal and Lissamine Green
  Uses dyes to observe abnormal cells on the surface of the eye.



• Slit-Lamp Exam
  Indicates the volume of tears by magnifying the eye and viewing it in its resting state.

The dental tests include:

• Parotid Gland Flow
  Measures the amount of saliva produced over a certain period of time.



• Salivary Scintigraphy
  Measures salivary gland function.



• Sialography
  An x-ray of the salivary-duct system.



• Lip Biopsy
  Used to confirm lymphocytic infiltration of the minor salivary glands.

More information about commonly ordered laboratory tests can be found at http://www.labtestsonline.org/

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