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Suspected Sjögren syndrome — SCE Rheumatology MCQ

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ModerateConnective tissue diseasesSuspected Sjögren syndromeSCE Rheumatology

A 47-year-old woman has troublesome dry eyes and mouth with fatigue. Examination shows no synovitis or parotid mass is present. Investigations show ANA is positive but anti-Ro and anti-La are negative. What is the most appropriate investigation?

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Correct answer: D — Labial salivary gland biopsy

Labial salivary gland biopsy can support Sjögren diagnosis when sicca symptoms are present but standard autoantibodies are negative. Anti-CCP testing is more relevant to rheumatoid arthritis. Objective dryness testing and histology prevent overdiagnosis based on subjective dryness alone.

Reference: BSR Sjögren disease guideline; EULAR Sjögren recommendations