Jack: I sure hope that clinicians do not read this abstract and title in a vacuum and assume "isolated SSB is not seen in CTDs!" I certainly have several SLE pts with this (SSB but neg SSA); this study actually had a 20% prevalence of CTD at evaluation. We must remind ourselves that autoantibodies can appear years before dz onset, and Sjogren's syndrome especially can have a slow/gradual onset over many years' time. I would change the wording to "Isolated SSB is seen with CTDs but is not specific for Sjogren's syndrome". Also, my plan for the patient with isolated SSB who does not currently have evidence for a CTD would be: educate the patient about the symptoms of CTD and see me ASAP if any occur, but also, I'd follow the patient clinically over time to see if a CTD does occur in the hopes of catching it at an early, more easily treated stage. (Reference: MR Arbuckle et al. N Engl J Med 2003;349:1526-33)