How do you approach the management of a patient with strongly positive SSA antibodies and an extraglandular feature such as ILD or peripheral neuropathy, but without sicca symptoms or parotid abnormalities?

The ACR/EULAR 2016 criteria are clear that a patient with a +SSA antibody needs to also have some degree of measurable sicca in order to be clinically diagnosed with SjD. In my experience, many patients may not perceive that they are dry because they have been able to tolerate the symptoms over time...

Thank you for raising this important question. It underscores both the value of the 2016 ACR/EULAR classification criteria as a diagnostic framework and the inherent challenges in diagnosing Sjögren’s disease, particularly since objective dryness measures and labial salivary gland biopsies are not r...

This is a timely question, with disease-modifying biologics probably just around the corner. I agree with doctors @Ghaith Noaiseh and @Teresa K. Tarrant.

I'll just simply recommend that all rheumatologists should have in their office:

Schirmer's papers

Containers (e.g., Dixie cups or volume tube col...