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RTX Hypogammaglobulinaemia — SCE Rheumatology MCQ

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HardVasculitisRTX HypogammaglobulinaemiaSCE Rheumatology

An anti-Ro-negative patient has persistent objective ocular and oral dryness. Salivary-gland ultrasound is strongly abnormal and no exclusion diagnosis is found. How should ultrasound be used when applying adult Sjögren classification?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Use ultrasound as supportive evidence without replacing serology or biopsy

Explanation lettering: C = shown as A · A = shown as B · D = shown as C · E = shown as D · B = shown as E

E is correct. BSR supports salivary-gland ultrasound as useful additional information, with good correlation with gland histology, but it is not currently part of the adult ACR/EULAR classification criteria and does not replace antibody testing or biopsy. In anti-Ro-negative objective sicca, a labial salivary-gland biopsy may provide the weighted criterion needed for classification and useful prognostic information. A normal or abnormal scan changes probability; it does not act as a stand-alone rule-in or rule-out test.

Reference: BSR guideline on adult and juvenile-onset Sjögren disease: https://pmc.ncbi.nlm.nih.gov/articles/PMC12013823/