Sjögren Anti-Ro Anti-La — ORE Part 1 MCQ

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ModerateOral MedicineSjögren Anti-Ro Anti-LaORE Part 1

A 45-year-old woman presents with bilateral submandibular gland enlargement. She reports dry eyes and recurrent cervical dental caries. Schirmer’s test shows less than 5 mm wetting in 5 minutes. Which blood test would be most helpful in supporting the suspected diagnosis?

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Correct answer: A — Anti-SSA/Ro antibody test

The sicca symptoms, recurrent cervical caries from reduced salivary protection, salivary-gland enlargement and Schirmer’s result of less than 5 mm in 5 minutes suggest Sjögren’s disease. Anti-SSA/Ro is the most useful listed serological test: it is a key immunological marker in the ACR/EULAR classification criteria and, with the abnormal Schirmer test, supports the diagnosis. Anti-La/SSB may occur with Sjögren’s disease but isolated anti-La is less specific and is not the core antibody in current criteria. Full blood count, liver and thyroid function tests may identify associated abnormalities or autoimmune comorbidity, but do not confirm Sjögren’s disease. Serum calcium is not a diagnostic test for this presentation.

Reference: Shiboski CH et al. 2016 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Primary Sjögren's Syndrome, 2017. https://www.ouh.nhs.uk/immunology/diagnostic-tests/tests-catalogue/ena-screen/