Which tests may be considered in the diagnosis of Sjögren syndrome?

Updated: Mar 05, 2021
  • Author: Sriya K Ranatunga, MD, MPH; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Other test results to consider are as follows:

  • High total protein level or a low albumin level - Should prompt the clinician to perform serum protein electrophoresis

  • High alkaline phosphatase level - Should prompt consideration of primary biliary cirrhosis

  • Elevated transaminase levels - Consider the possibility of chronic active hepatitis, which can be associated with sicca symptoms, or hepatitis C, which can cause mild salivary gland enlargement; however, mild (< 2-fold) increases in transaminase levels have been observed in 22% of patients with Sjögren syndrome [70]

  • Low bicarbonate level - Consider evaluating patients with a low bicarbonate level for type I (distal) renal tubular acidosis; less commonly, patients can also develop proximal renal tubular acidosis with Fanconi syndrome

  • Hypokalemia - This condition, which is occasionally severe enough to lead to periodic paralysis, can be observed in patients with type I renal tubular acidosis; however, it can also be observed in patients who have Sjögren syndrome without renal tubular acidosis [46]


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