While I applaud the search for less invasive diagnostic tests for Sjogren’s, this study and other recent efforts reflect the misunderstanding of Sjogren’s as primarily a dryness (sicca) disease. 🧵 www.healio.com/news/rheumat... - ThreadSky

sarahschafermd.bsky.social • 103 days ago

While I applaud the search for less invasive diagnostic tests for Sjogren’s, this study and other recent efforts reflect the misunderstanding of Sjogren’s as primarily a dryness (sicca) disease. 🧵 https://www.healio.com/news/rheumatology/20250113/noninvasive-salivabased-sjgrens-diagnosis-model-shows-good-performance

Comments

megpark.bsky.social•103 days ago

Wait. You all have saliva in January?

sarahschafermd.bsky.social•103 days ago

@gohealio.bsky.social

sarahschafermd.bsky.social•103 days ago

The overemphasis on testing salivary/lacrimal glands is misguided. New classification criteria (CC) are needed, but they should reflect the broad array of systemic manifestations, not double down on finding better sicca tests.

sarahschafermd.bsky.social•103 days ago

It is time to add systemic features to the diagnostic toolkit. Until that happens, clinicians will continue to be led astray by the Sjogren’s=Sicca myth

sarahschafermd.bsky.social•103 days ago

Sjogren’s is a multi-system disease, never limited to sicca. 20% of people with Sjogren’s present without sicca (dryness), leading to extreme delays in diagnosis. Some people may have Sjogren’s and never develop measurable sicca.

sarahschafermd.bsky.social•103 days ago

The CC overweight sicca, even though systemic manifestations can be found in nearly every Sjogren’s patient if you look for them. The CC must be updated to reflect systemic manifestations, and the significant burden of systemic manifestations must be communicated with clinicians.

sarahschafermd.bsky.social•103 days ago

Neuro manifestations (especially dysautonomia, and small fiber neuropathy), lung disease (multiple types), and joint involvement each impact over 50% but are often overlooked or misattributed to other conditions.

sarahschafermd.bsky.social•103 days ago

My pinned thread links to studies demonstrating that >80% with Sjogren’s have systemic disease as measured by the ESSDAI. These studies underestimate systemic involvement, in part by excluding non-ESSDAI manifestations, such as Raynaud’s, GI manifestations, and dysautonomia.

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