From the Guidelines
Baseline evaluation of salivary gland function is crucial before starting treatment for oral dryness, and should include measuring whole salivary flows and ruling out SjS-unrelated conditions. To evaluate salivary gland function in patients with atrophic salivary glands, laboratory tests such as salivary flow rate measurements, blood tests, and imaging studies should be considered.
Key Laboratory Tests
- Salivary flow rate measurements: unstimulated and stimulated salivary flow rates should be measured to assess glandular function, with rates below 0.1 mL/min for unstimulated and below 0.5-0.7 mL/min for stimulated flow indicating hyposalivation 1.
- Blood tests: complete blood count, comprehensive metabolic panel, and autoimmune markers like ANA, anti-SSA/Ro, and anti-SSB/La antibodies to identify underlying conditions such as Sjögren's syndrome.
- Imaging studies: ultrasound, MRI, or CT scans can assess structural changes in the glands, with ultrasound being particularly useful for salivary gland diseases 1.
Additional Diagnostic Tools
- Salivary gland biopsy: may be necessary to confirm diagnoses like Sjögren's syndrome, showing lymphocytic infiltration and acinar atrophy.
- Questionnaires: such as the Brief Pain Inventory, Beck Depression Inventory, Hospital Anxiety and Depression Scale, McGill Pain Questionnaire, and Oral Impacts on Daily Performance (OHIP) can help in assessment and monitoring of effects of therapy 1. These tests help determine the cause of salivary gland atrophy, which could result from autoimmune disorders, radiation therapy, medications, dehydration, or aging, allowing for appropriate treatment planning, as recommended by the EULAR guidelines for the management of Sjögren's syndrome 1.
From the Research
Atrophic Salivary Glands Labs
- Laboratory tests for atrophic salivary glands may include a complete blood count with differential, a comprehensive metabolic panel, measurement of inflammatory markers and autoantibodies, and flow cytometry 2
- Saliva tests can be used to measure hormone levels, including steroids, and can be used to identify or monitor clinical conditions such as adrenal disorders or androgen deficiency 3
- A complete blood count (CBC) can be used to assess cardiovascular and metabolic diseases, and may include markers such as white blood cell count, neutrophil-to-lymphocyte ratio, and platelet count 4
- Laboratory evaluation of a suspected autoimmune illness, such as Sjögren's syndrome which can cause atrophic salivary glands, in conjunction with a thorough clinical evaluation provides a better understanding of a patient's immunologic disease 2
- There is no direct evidence in the provided studies that links these laboratory tests to atrophic salivary glands specifically, but they may be useful in evaluating underlying conditions that could be contributing to the atrophy 2, 3, 4, 5