Sjögren’s syndrome (SS), a complex autoimmune rheumatic disease that specifically targets salivary and lachrymal glands, could be a disorder of immune system. It is identified by its two most typical symptoms — dry eyes and a xerostomia. The condition often accompanies other immune system disorders, like rheumatoid arthritis and lupus. In Sjogren’s syndrome, the mucous membranes and moisture-secreting glands of eyes and mouth are usually affected first — cause decreased tears and saliva. Although Sjogren’s syndrome will develop at any age, most of the people are older than 40 at the time of diagnosis. The condition is far more common in women. Treatment focuses on relieving symptoms.
Panel test:
Immunologic tests:
• Antinuclear antibody (ANA): Commonly found in the blood of patients who have Sjogren’s syndrome. This test is useful for initial screen (not disease-specific); In people with a positive ANA, more tests are usually performed to check for other antibodies that can help to confirm the diagnosis.
• Extractable Nuclear Antibody Tests
o anti-SSA (also called anti-Ro) Anti-SSA antibodies are detected in two thirds of Sjögren disease patients.
o anti-SSB (anti-La) is an important component of the ACR/EULAR classification criteria for primary Sjögren syndrome.
• Rheumatoid factor (RF). RF testing is usually used as part of the workup for Sjögren syndrome, as RF is detected in about half of patients
• levels of immunoglobulin. Patients can have hypergammaglobulinemaia
• Novel Autoantibodies:
o anti-salivary gland protein 1 SP-1
o anti-carbonic anhydrase 6 CA-6
o anti-parotid secretory protein PSP– Antibodies (IgG, IgM & IgA of SP-1, CA6 and PSP are helpful markers for diagnosis of patients with SS at early stages of the disease or those that lack antibodies to either Ro or La.
• BETA2-MG
• Cryoglobulins
References:
1. Mariette X, Criswell LA. Primary Sjögren’s Syndrome. N Engl J Med. 2018; 378(10): 931-939. PubMed
2. Beckman KA, Luchs J, Milner MS. Making the diagnosis of Sjögren’s syndrome in patients with dry eye. Clin Ophthalmol. 2016; 10: 43-53. PubMed
