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Diagnostic Tests for Sjogren's Syndrome

Sjogren's Syndrome: Diagnostic Tests

The list of diagnostic tests mentioned in various sources as used in the diagnosis of Sjogren's Syndrome includes:

Home Diagnostic Testing

These home medical tests may be relevant to Sjogren's Syndrome:

Tests and diagnosis discussion for Sjogren's Syndrome:

The doctor will first take a detailed medical history, which includes asking questions about general health, symptoms, family medical history, alcohol consumption, smoking, or use of drugs or medications. The doctor will also do a complete physical exam to check for other signs of Sjögren's.

You may have some tests, too. First, the doctor will want to check your eyes and mouth to see whether Sjögren's is causing your symptoms and how severe the problem is. Then, the doctor may do other tests to see whether the disease is elsewhere in the body as well.

Common eye and mouth tests are

  • Schirmer test--This test measures tears to see how the lacrimal gland is working. It can be done in two ways: In Schirmer I, the doctor puts thin paper strips under the lower eyelids and measures the amount of wetness on the paper after 5 minutes. People with Sjögren's usually produce less than 8 millimeters of tears. The Schirmer II test is similar, but the doctor uses a cotton swab to stimulate a tear reflex inside the nose.

  • Staining with vital dyes (rose bengal or lissamine green)--The tests show how much damage dryness has done to the surface of the eye. The doctor puts a drop of a liquid containing a dye into the lower eye lid. These drops stain on the surface of the eye, highlighting any areas of injury.

  • Slit lamp examination--This test shows how severe the dryness is and whether the outside of the eye is inflamed. An ophthalmologist (eye specialist) uses equipment that magnifies to carefully examine the eye.

  • Mouth exam--The doctor will look in the mouth for signs of dryness and to see whether any of the major salivary glands are swollen. Signs of dryness include a dry, sticky mouth; cavities; thick saliva, or none at all; a smooth look to the tongue; redness in the mouth; dry, cracked lips; and sores at the corners of the mouth. The doctor might also try to get a sample of saliva to see how much the glands are producing and to check its quality.

  • Salivary gland biopsy of the lip--This test is the best way to find out whether dry mouth is caused by Sjögren's syndrome. The doctor removes tiny minor salivary glands from the inside of the lower lip and examines them under the microscope. If the glands contain lymphocytes in a particular pattern, the test is positive for Sjögren's syndrome.

Because there are many causes of dry eyes and dry mouth, the doctor will take other possible causes into account. Generally, you are considered to have definite Sjögren's if you have dry eyes, dry mouth, and a positive lip biopsy. But the doctor may decide to do additional tests to see whether other parts of the body are affected. These tests may include

  • Routine blood tests--The doctor will take blood samples to check blood count and blood sugar level, and to see how the liver and kidneys are working.

  • Immunological tests--These blood tests check for antibodies commonly found in the blood of people with Sjögren's syndrome. For example:

    Antithyroid antibodies are created when antibodies migrate out of the salivary glands into the thyroid gland. Antithyroid antibodies cause thyroiditis (inflammation of the thyroid), a common problem in people with Sjögren's.

    Immunoglobulins and gamma globulins are antibodies that everyone has in their blood, but people with Sjögren's usually have too many of them.

    Rheumatoid factors (RFs) are found in the blood of people with rheumatoid arthritis, as well as in people with Sjögren's. Substances known as cryoglobulins may be detected; these indicate risk of lymphoma.

    Similarly, the presence of antinuclear antibodies (ANAs) can indicate an autoimmune disorder, including Sjögren's.

    Sjögren's antibodies, called SS-A (or SS-Ro) and SS-B (or SS-La), are specific antinuclear antibodies common in people with Sjögren's. However, you can have Sjögren's without having these ANAs.

  • Chest x ray--Sjögren's can cause inflammation in the lungs, so the doctor may want to take an x ray to check them.

  • Urinalysis--The doctor will probably test a sample of your urine to see how well the kidneys are working.

(Source: excerpt from Questions and Answers About Sjögren's Syndrome: NIAMS)

Diagnosis of Sjogren's Syndrome: medical news summaries:

The following medical news items are relevant to diagnosis of Sjogren's Syndrome:

 

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