Diagnostic Challenges in Sjogren’s Disease

In this segment, the panel discusses why diagnosing Sjögren’s Disease (SjD) is often complicated and delayed. Many patients present with vague or nonspecific symptoms, such as fatigue, mild dryness, or joint pain, which may be attributed to stress, aging, or other conditions. Serologic testing is not always definitive, as a significant portion of patients with SjD—over 30%—may test negative for SSA antibodies, making reliance on bloodwork alone insufficient. Additionally, access to diagnostic tools such as salivary gland ultrasound or appropriately performed minor salivary gland biopsy varies widely across clinical settings, especially in community practices.

The panel notes that clinicians must take a careful, symptom-driven history, asking targeted questions about dryness, dental issues, and systemic symptoms that patients may not volunteer. Environmental factors, such as living in dry climates, can further complicate interpretation. Ultimately, effective diagnosis requires clinical suspicion, objective testing, and multidisciplinary awareness to reduce delays in care.