There is no single test to diagnose Sjögren disease. Doctors will carry out a range of tests, such as blood, eye, and salivary gland tests, to look for signs of the disorder and rule out other conditions.

Sjögren disease is an autoimmune disorder that causes dry eyes and mouth.

This article outlines the diagnostic tools used to help diagnose Sjögren disease.

A doctor looking through a microscope to look for markers of Sjögren diseaseShare on Pinterest
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According to the Sjogren’s Foundation, healthcare professionals can have difficulty recognizing and diagnosing Sjögren disease, as the symptoms can overlap with other conditions and medication side effects.

Symptoms of Sjögren disease can affect various parts of the body and can also occur at different times. This can mean that an eye doctor treating dry eyes may not identify other symptoms, such as joint pain.

According to the foundation, it may take around 2.8 years to receive a diagnosis of Sjögren disease, but this is almost half the time it used to take.

There is no single test to diagnose Sjögren disease. Instead, doctors use different tests to look for signs throughout the body and rule out other possible causes.

A rheumatologist, a doctor who specializes in autoimmune diseases, may diagnose Sjögren disease. However, a person may also work with other specialists, such as eye doctors or dentists, to receive a diagnosis.

At first, a doctor will perform a physical exam, assess symptoms, and take a medical history. They may then carry out the following tests.

Blood tests can detect certain antibodies in those with Sjögren disease. However, these antibodies can also occur in people without the condition. This is why blood tests are helpful but cannot make a complete diagnosis.

Blood tests can detect autoantibodies, which are antibodies that target a person’s own tissues. Autoantibodies linked with Sjogren’s syndrome include:

  • anti–Sjögren-syndrome-related antigen A (anti-SSA)
  • anti–Sjögren-syndrome-related antigen B (anti-SSB)
  • antinuclear antibody (ANA)
  • rheumatoid factor (RF)

Blood tests can also show inflammation, which can indicate Sjögren disease. The tests may show:

  • increased levels of immunoglobulins, a type of antibody that can indicate an overreactive immune system
  • increased levels of C-reactive protein, which indicates inflammation

An erythrocyte sedimentation rate uses a blood sample to measure how fast red blood cells sink to the bottom of a test tube to show if people have inflammation.

Schirmer’s test measures the level of tears in the eyes and helps diagnose dry eyes.

A doctor places a strip of filter paper against the eyelids to allow tears to travel across the paper. After 5 minutes, a doctor will remove the strips and measure how much of the paper the tears have moistened.

If tears have wetted less than 5 millimeters of the paper, it indicates dryness.

Other eye tests

Doctors may also carry out other eye tests to check for dryness, such as:

  • Slit lamp exam: A slit lamp uses a microscope and light to examine the structures of the eye. A slit lamp exam can show if there is any damage to the surface of the eye due to dryness.
  • Ocular surface staining: Ocular surface staining involves a doctor applying specialist eye drops, which add a dye to the surface of the eye. If the dye does not disperse evenly across the tear film, it can indicate dryness.

A salivary gland scintigraphy is an imaging scan to check the function of the salivary glands.

Scintigraphy uses a radioactive substance to produce an image of the salivary glands. A doctor will give people a sour substance, such as lemon juice, to stimulate the salivary glands.

This can help doctors check saliva production and see how well the glands are functioning.

A salivary gland biopsy involves taking a tissue sample of the salivary glands for examination.

Doctors usually perform a biopsy on the lower lip, as it is easier to carry out the procedure, and there is little risk of excessive bleeding.

The biopsy checks for signs of inflammation within the salivary glands, which can adversely affect how they function.

Ultrasound is an imaging scan that uses sound waves to create an image of internal tissues and organs in the body.

Doctors may use a salivary gland ultrasound to examine the glands for abnormalities that may be present with Sjögren disease.

Sjögren disease can cause inflammation in the lungs, so doctors may carry out a chest X-ray to create an image of the lungs and check for any problems.

Signs to contact a doctor about a diagnosis include persistent dry eyes and mouth. A person may experience:

Sjögren disease can also affect the rest of the body and may cause:

What are the symptoms of Sjögren disease?

The most common symptoms of Sjögren disease are dry eyes and mouth. Other symptoms may include fatigue, joint and muscle pain, and dry skin.

How is Sjögren disease treated?

Treatment for Sjögren disease focuses on managing symptoms and preventing complications.

Depending on the affected parts of the body, treatment options may include eye drops, artificial saliva, and medication to target inflammation and pain.

What happens if a person does not receive treatment for Sjögren disease?

Without treatment, Sjögren disease may lead to complications. An early diagnosis and correct treatment can help prevent complications and improve quality of life.

There is no single test to diagnose Sjögren disease. Instead, doctors use a range of tests to check for various signs and symptoms of the disease.

Diagnostic tests may include blood tests, eye tests, and tests to assess salivary gland function and check for signs of inflammation.