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Tests and diagnosis
By Mayo Clinic staffSjogren's syndrome can be difficult to diagnose because the signs and symptoms vary from person to person, and can be similar to those caused by other diseases. Side effects of a number of medications can mimic some signs and symptoms of Sjogren's syndrome.
A variety of tests can help rule out other conditions and help pinpoint a diagnosis of Sjogren's syndrome.
Blood tests
Your doctor may order blood tests to check for:
- Levels of different types of blood cells
- Presence of antibodies common in Sjogren's syndrome
- Blood glucose levels
- Evidence of inflammatory conditions
- Indications of problems with your liver and kidneys
Eye tests
- Shirmer test. Your doctor can measure the dryness of your eyes with a test called a Schirmer tear test. In this test, a small piece of filter paper is placed under your lower eyelid to measure your tear production.
- Slit-lamp test. An ophthalmologist, a physician specializing in the treatment of eye disorders, may also examine the surface of your eyes with a magnifying device called a slit lamp. He or she may place a drop of liquid containing a dye in your eye to make any damage to your cornea easier to see.
Imaging
- Sialogram. To check on the condition of your salivary glands, your doctor may order a special X-ray called a sialogram. It detects dye that's injected into your parotid glands, located behind your jaw and in front of your ears. This procedure shows how much saliva flows into your mouth.
- Salivary scintigraphy. This nuclear medicine test involves the injection of a radioactive isotope, which is tracked to measure your salivary gland function.
- Chest X-ray. Because Sjogren's syndrome can also cause lung inflammation, your doctor may also order a chest X-ray.
Biopsy
Your doctor may also want to do a lip biopsy to detect the presence of clusters of inflammatory cells, which can indicate Sjogren's syndrome. For this test, a small sliver of tissue is removed from salivary glands located in your lip and examined under a microscope.
Other tests
- Spit test. In this test, you spit into a test tube every minute for 15 minutes. The total amount of saliva collected is then measured to determine the severity of your dry mouth.
- Urine sample. Your doctor may want you to provide a urine sample that can be analyzed in the laboratory to determine whether Sjogren's syndrome has affected your kidneys.
- Questions and answers about Sjogren's syndrome. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Sjogrens_Syndrome/sjogrens_syndrome_qa.pdf. Accessed May 15, 2009.
- Kruszka P, et al. Diagnosis and management of Sjogren syndrome. American Family Physician. 2009;79:465.
- Naguwa S, et al. Sjogren's syndrome. In: Goldman L, et al. Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/137554062-3/841563606/1492/1035.html#4-u1.0-B978-1-4160-2805-5..50294-9_13050. Accessed May 15, 2009.
- Sjogren's syndrome. American College of Rheumatology. http://www.rheumatology.org/public/factsheets/diseases_and_conditions/sjogrens.asp. Accessed May 15, 2009.
- Fox R, et al. Treatment of Sjogren's syndrome. http://www.uptodate.com/home/index.html. Accessed May 20, 2009.
- Chang-Miller A (expert opinion). Mayo Clinic, Rochester, Minn. June 1, 2009.
