Sjögren Syndrome — ORE Part 1 MCQ

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ModerateOral MedicineSjögren SyndromeORE Part 1

A 30-year-old woman presents with bilateral painful swelling of the parotid glands. She has dry eyes and dry mouth. Blood tests show positive anti-Ro (SSA) and anti-La (SSB) antibodies. What is the most likely diagnosis?

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Correct answer: E — Sjögren syndrome

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

The correct answer is A: Sjögren syndrome. Anti-La (SSB) antibodies are highly specific for Sjögren syndrome, and their presence alongside anti-Ro (SSA) antibodies in a patient with bilateral parotid swelling and sicca symptoms (dry eyes and mouth) is diagnostic. The patient meets American-European Consensus diagnostic criteria for primary Sjögren syndrome: oral symptoms (parotid swelling, dry mouth), ocular symptoms (dry eyes), and autoantibodies (anti-Ro/anti-La). Sarcoidosis (B) can cause parotid swelling and dry eyes but lacks the characteristic anti-Ro/anti-La serology. HIV-associated salivary gland disease (C) and mumps (E) do not produce these autoantibodies. IgG4-related disease (D) presents with different serology and tissue pathology and is an exclusion criterion for Sjögren syndrome diagnosis.

Reference: Anti-Ro (SSA)/La (SSB) antibodies and Sjögren's syndrome. PubMed. 1989. https://pubmed.ncbi.nlm.nih.gov/2203591/; Remedy BNSSG ICB. Sjögren's Syndrome. NHS. https://remedy.bnssg.icb.nhs.uk/adults/rheumatology/sjorgrens-sydrome/