In what circumstances do you pursue labial salivary gland biopsy in an asymptomatic patient with high titer ANA and positive SSA?

Topics: Rheumatology • Sjogren’s syndrome

How do you risk stratify and monitor such patient for disease progression or organ involvement?

Answer from: at Academic Institution

I seldom, if ever, suggest a lip biopsy in the work-up of patients with Sjogren's syndrome. It is invasive, and even the histo-pathological interpretation is often open to question. I typically refer patients to an ophthalmologist for a diagnosis of keratoconjunctivitis sicca, if present, and if nec...

Comments

at University of California, Berkeley and San Francisco
I am fortunate to be working with Ava Wu DDS, dire...

at Uniformed Services University of the Health Sciences (USUHS)
@Nancy L. Carteron: I wish we all had Ava close by...

Answer from: at Community Practice

Utilize the framework of the 2016 ACR/EULAR Classification Criteria (not diagnostic) that have been validated in 3 separate international cohorts (Shiboski et al., PMID 27785888). Generally, the patient would present with some suggestive symptoms/features (i.e., dry eye/mouth). Total of 4 points c/w...

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