Screening and diagnosis
To diagnose Sjogren's syndrome, your doctor will most likely ask for a
history of your symptoms, including what they are and how long you've
had them. He or she will also want to discuss other conditions you may
have and medications you're taking. Your doctor may ask about your diet,
including the types and quantities of liquids that you drink in a day.
Beyond reviewing your medical history, your doctor can use a variety of
tests to diagnose Sjogren's syndrome:
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Blood tests.
Your doctor may order blood tests to check your blood counts and
sedimentation rate and to check for autoantibodies. Checking your
blood count lets your doctor know the proportion of the various
types of blood cells in a given volume of your blood. Sedimentation
rate refers to the speed at which the red blood cells settle to the
bottom of a column of blood in a glass tube. Certain inflammatory
conditions increase the sedimentation rate. Autoantibodies can play
a role in the inflammatory response, which can damage your tissues
and organs.
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Tear test.
Your doctor can measure the dryness of your eyes with a Schirmer
tear test, in which a small piece of filter paper is placed under
your lower eyelid to measure your tears. A medical eye doctor
(ophthalmologist) may also examine your eyes with a slit lamp after
placing a drop of rose bengal dye in your eye. The dye stains areas
of the cornea that have been damaged by the dryness. An
ophthalmologist may also place a drop of fluorescein dye on your eye
and measure the time between the last blink and when the dye begins
to disappear from the tear film.
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Imaging.
To check on the condition of your salivary glands, your doctor may
order a special X-ray called a sialogram. It detects dye that is
injected into your parotid glands, located behind your jaw and in
front of your ears. The dye is injected through the opening of a
small duct in your mouth. This procedure reveals the flow of saliva
into your mouth. Your doctor may also perform a parotid gland flow
test to determine the amount of saliva that you produce over time.
And a salivary scintigraphy measures your salivary gland function.
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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.
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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.
Sjogren's syndrome
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