Best of 2024: Diagnosing Seronegative Sjogren's Disease Save

Editor's note: this article originally appeared August 28, 2024 and is being shared again as a Best of 2024. Enjoy!

Sjögren disease (SjD) is highly prevalent, but diagnosis may be challenged if anti-SSA antibodies or a labial salivary gland biopsy are negative. A recent cohort analysis suggests a novel autoantibody profile has predictive value SSA negative SjD and also in those with a positive labial biopsy.

It is estimated that one-third of SjD patients lack anti-SSA antibodies (SSA−), thereby requiring a positive biopsy and focus score (FS) for diagnosis. 

IgG autoantibody binding was assess in 3 cohorts: a) SSA− SjD (n=76), b) sicca-controls without autoimmunity (n=75) and c) autoimmune-feature controls (SjD features but not meeting SjD criteria; n=41). 

They found IgG binding to D-aminoacyl-tRNA deacylase (DTD2) more in SSA− SjD compared to sicca-controls (p=0.004) and combined controls (sicca-controls and autoimmune-feature controls combined; p=0.003). 

IgG against peptides from retroelement silencing factor-1 and DTD2 were also found more frequently in FS-positive than FS-negative participants (p=0.010; p=0.012). 

These findings require further study to delineate their utility in diagnosing SjD, especially those who are seronegative for SSA antibodies.