Diagnostic Approaches in Sjogren’s Disease

This segment focuses on how clinicians evaluate suspected Sjögren’s Disease (SjD) using a combination of serologic testing, objective glandular function tests, imaging, and biopsy. The discussion begins with the importance of checking SSA/Ro antibodies (including Ro52 and Ro60 separately) and assessing markers such as hypergammaglobulinemia, hypocomplementemia, and cytopenias as supportive immunologic clues. The panel emphasizes simple in-clinic tests such as Schirmer’s test and unstimulated salivary flow, which provide rapid insight into tear and salivary gland function. Salivary gland ultrasound has become an important noninvasive tool, particularly when interpreted with standardized scoring systems, and may suggest SjD when hypoechoic lesions are present.

The role of minor salivary gland biopsy is highlighted—not only for meeting classification criteria when serology is negative, but also for its emerging value in assessing tissue damage, predicting lymphoma risk, and guiding therapeutic decision-making. Proper technique and experienced pathology interpretation are essential.