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Old 11-28-2012, 11:56 PM   #1
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What tests are there to check for sjogren's?

Hi, I've had very red eyes for quite some time now. Had it checked and was diagnosed with severe dry eye. Dr gave me prescription eye drops. I did research later to see what causes dry eyes and ran across sjogren's. for about 3 years now I've had many of the symptoms and they've for the most part gotten worse. Joint pain & stiffness, very dry red eyes, always sucking on hard candies due to mouth dryness, very flakey dry skin, nose & airways feeling dry.

So my question is, what tests are there to diagnose or rule this out?
I'm nearing age 38 & just assumed these symptoms were normal as I age. I haven't complained much to my dr about my joint pains cause I mentioned it once and she said oh you're too young to be having joint problems and brushed it off. I was actually there that time for lung infection which I seem to get a couple times a year. I figured due to being a smoker. There's always been something I do in my life that I felt I can blame most of the symptoms on so I've not thought too much about them till the last 6 months. My eyes are horribly red/dry and there's nothing I can blame that on. If you put all the symptoms together it falls in place with sjogren's.

 
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Old 11-29-2012, 07:05 AM   #2
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Re: What tests are there to check for sjogren's?

These are the current criteria for diagnosis in North America and Europe, I believe:
According to the American-European classification system (as modified by Tzioufas and Voulgarelis[4] ), diagnosis of primary Sjögren syndrome requires 4 of 6 of the below criteria; in addition, either criterion number 5 or criterion number 6 must be included. Sjögren syndrome can be diagnosed in patients who have no sicca symptoms if 3 of 4 objective criteria are fulfilled. The criteria are as follows:

Ocular symptoms - Dry eyes for more than 3 months, foreign-body sensation, use of tear substitutes more than 3 times daily
Oral symptoms - Feeling of dry mouth, recurrently swollen salivary glands, frequent use of liquids to aid swallowing
Ocular signs - Schirmer test performed without anesthesia (< 5 mm in 5 min), positive vital dye staining results
Oral signs - Abnormal salivary scintigraphy findings, abnormal parotid sialography findings, abnormal sialometry findings (unstimulated salivary flow < 1.5mL in 15min)
Positive minor salivary gland biopsy findings
Positive anti–SSA or anti–SSB antibody results

Of course, secondary Sjogren's has different criteria and there are exclusion criteria as well. And of course, I'm just a patient who has secondary Sjogren's at that. So consult with your Dr. There may be other diagnostic criteria that can be used as well, so these are just the ones I know about. I also wanted to mention that there may be a new set of criteria for research purposes, as well. So there is a certain amount of updating going on as more knowledge is gained.

Last edited by luca689; 11-29-2012 at 07:09 AM. Reason: adding info

 
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Old 11-29-2012, 02:37 PM   #3
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Re: What tests are there to check for sjogren's?

You can ask your internist or a rheumatologist to do some blood tests. I think that most typically, they would test for RF, ANA, and SSA and SSA for Sjogrens. The trouble is that some people (like me) test negative for everything, but still have symptoms. My doctor's approach is not worry about the textbook diagnosis, but to treat symptoms. So, I take Evoxac for oral dryness and use humidifiers at home and at work. I use OTC eye drops, but my eyes are generally not a problem for me. Because how the symptoms are treated doesn't really vary much whether your blood work says "Sjogrens" or not, getting a definitive answer doesn't do much, IMO. But if you really need to know, you could ask about getting a lip biopsy. You can get a permanently numb lip from that, however, so think about it before you do it.

 
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Old 11-29-2012, 03:53 PM   #4
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Re: What tests are there to check for sjogren's?

Numb lip for ever? No thanks. I think for sure at least do the other tests you all mentioned. If negative then I still need to treat at least some of these symptoms. Mostly the dry eyes and joint swelling/pain. The dry mouth thing is still not terrible yet although I can't swallow nuts or pills without them getting stuck in throat unless I eat them smothered in apple sauce they just won't slip on down throat. I do get sores in my mouth once in a while that are SO painful. Have to be careful what I eat those times. Has to be soft and no seasoning/spice at all or it burns like salt in a wound.

 
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Old 11-29-2012, 04:03 PM   #5
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Re: What tests are there to check for sjogren's?

Quote:
Originally Posted by t_411 View Post
Numb lip for ever? No thanks. I think for sure at least do the other tests you all mentioned. If negative then I still need to treat at least some of these symptoms. Mostly the dry eyes and joint swelling/pain. The dry mouth thing is still not terrible yet although I can't swallow nuts or pills without them getting stuck in throat unless I eat them smothered in apple sauce they just won't slip on down throat. I do get sores in my mouth once in a while that are SO painful. Have to be careful what I eat those times. Has to be soft and no seasoning/spice at all or it burns like salt in a wound.
I would definitely talk to your doctor about getting a prescription for Evoxac. Many people find that it helps them with dry mouth and also dry eyes.

 
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