26th January 2024

Differential Diagnosis

Most differential diagnoses of SS can be excluded by taking an in-depth history, physical examination and serological testing. 

• Age-related sicca syndrome: Age-related ocular and oral dryness may mimic features of SS. However, patients with sicca syndrome would not have positive autoantibodies (Anti-Ro/SSA and Anti-la/SSB), which are present in 60-80% of patients with SS. 
• Sarcoidosis: Sarcoidosis may share some extra-glandular features similar to SS, including arthritis and interstitial nephritis. However, biopsy findings and serology for autoantibodies would help in differentiating both conditions. 
• Rheumatoid Arthritis: RA may have similar features to SS, such as arthritis and serological testing in both cases may show positive ANA autoantibodies and Rheumatoid factor positive antibodies. However, symptoms such as oral and ocular dryness would make a diagnosis of SS more likely.