Diagnosis of Sjogren's Syndrome
Diagnostic Test list for Sjogren's Syndrome:
The list of medical tests
mentioned in various sources as
used in the diagnosis of 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 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
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 and misdiagnosis issues for Sjogren's Syndrome:
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