Hi There, I've been a lurker for a while and there have been so many times I wanted to post out of frustration. This is one of those times! Here is a link to John Hopkins which provides the American-European Concesus for Criteria for Sjogren's. http://www.hopkinssjogrens.org/disease-information/diagnosis-sjogrens-syndrome/americaneuropean-consensus-criteria-sjgrens-syndrome/
"Lip biopsy showing focal lymphocytic sialoadenitis (focus score ≥1 per 4 mm2) "
I asked Dr. Carteron on ask the Dr. website at (http://www.sjogrensforum.com/ask-the-doctor/
) what her opinion was per the following question.
I have a positive ANA of 1:640, SSA/SSB negative. Other AI lab tests all
negative. My lip biopsy pathology reads as: Mild chronc inflammatory infiltrate
noted including one lymphocyte focus consisting of >50 lymphocytes.
(By the way my ANA is speckled.)
Her response was: A: Although the US-European Consensus Criteria for diagnosing Sjogrens are designed for defining groups for Research and should not be used soley for diagnosing pts in clinical practice, you would even meet the criteria for a diagnosis of Sjs and would be considered for a research trial. Whether you have primary or secondary Sjs depends on a full evaluation to exclude other autoimmune disorders. The US-EU Criteria use a Focus Score (lymphocyte group) of Greater than or Equal to ONE.
I don't have a formal diagnosis as of yet as I am waiting for an appointment with a rheumatologist specializing in Sjogrens, IF I get one with this Dr. I don't know if my report is going to suffice as the ENT who did the test may not have selected sizes of tissue large enough for the diagnosis.
I have to question how well an oral surgeon is familiar with the diagnostic criteria as advised on the website noted above. My ENT advised she was on the fence with the pathology report and recommended a rheumatologist to diagnose.
This criteria is also posted on Sjogren's Foundation Org website: http://www.sjogrens.org/home/about-sjogrens-syndrome/healthcare-providers/diagnosis-criteria
"IV. Histopathology Lip biopsy showing focal lymphocytic sialoadenitis
(focus score ≥1 per 4 mm2)2"
Please note there are other factors that need to be ruled out in order to obtain one of those *in the box* diagnosis. However, *clinically, you CAN be diagnosed and treated if you find the right Dr.