What laboratory tests are used to rule out Sjögren's (Sjögren's syndrome)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: February 26, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

To rule out Sjögren's syndrome, laboratory tests such as SSA, SSB, ANA, RF, SP1, CA6, and PSP should be ordered, as they are the most relevant diagnostic tests for this condition. When evaluating a patient for Sjögren's syndrome, it is essential to consider the presence of clinically significant dry eye and dry mouth symptoms, which warrant a high degree of suspicion for this condition 1. The diagnostic workup for Sjögren's syndrome should include serological examinations for anti-Sjögren syndrome A antibody (SSA or anti-Ro), anti-Sjögren syndrome B antibody (SSB or anti-La), rheumatoid factor, and antinuclear antibody, as these are the primary markers for this condition 1. Additionally, point-of-care tests that include traditional serology as well as additional biomarkers such as salivary protein 1 (SP1), carbonic anhydrase 6 (CA6), and parotid secretory protein (PSP) can be useful in diagnosing Sjögren's syndrome 1. Some key points to consider when ordering laboratory tests for Sjögren's syndrome include:

  • SSA and SSB antibodies are specific markers for Sjögren's syndrome
  • ANA is often positive in patients with Sjögren's syndrome
  • RF is frequently elevated in patients with Sjögren's syndrome
  • SP1, CA6, and PSP are additional biomarkers that may be useful in diagnosing Sjögren's syndrome It is crucial to note that Sjögren's syndrome can be primary or secondary to other autoimmune diseases, and comprehensive testing is necessary for accurate diagnosis and appropriate management 1.

From the Research

Laboratory Tests for Sjögren's Syndrome

To rule out Sjögren's syndrome, several laboratory tests can be used, including:

  • Autoantibody tests:
    • Anti-Sjögren's syndrome-related antigen A (SS-A/Ro) 2, 3
    • Anti-Sjögren's syndrome-related antigen B (SS-B/La) 2, 3
    • Antinuclear antibody (ANA) titers 2, 3
    • Rheumatoid factor (RF) 2, 3
  • Novel biomarkers:
    • Autoantibodies to proteins specific to the salivary and lacrimal glands, such as SP-1, PSP, and CA-6 2
    • Alpha-fodrin autoantibodies 4, 5
  • Other tests:
    • Minor salivary gland biopsy to exhibit focal lymphocytic infiltrates 3
    • Erythrocyte sedimentation rate (ESR) and complete blood count (CBC) 5
    • Latex agglutination test for estimating rheumatoid factor (RF) and antinuclear antibodies (ANA) 5

Diagnostic Criteria

The American College of Rheumatology advocates for diagnostic criteria that include the presence of signs/symptoms suggestive of Sjögren's syndrome along with at least two objective factors, such as traditional biomarker positivity, salivary gland biopsy findings, and/or presence of keratoconjunctivitis sicca 2.

Commercially Available Diagnostic Panels

The Sjö test is a commercially available diagnostic panel that incorporates testing for traditional Sjögren's syndrome biomarkers, as well as three novel, proprietary early biomarkers, which provide greater sensitivity and specificity than traditional biomarker testing alone 2.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.