By David Ivanov, Biochemistry and Molecular Biology, 2015

Sjogren’s syndrome, like other autoimmune diseases, can be difficult to diagnose definitively, and often relies on a handful of signs and symptoms that can vary substantially from case to case. The only signs considered markers for Sjogren’s are anti-SSA and anti-SSB antibodies, and while anti-SSB is more specific, elevated levels of anti-SSB are actually less common in patients with Sjogren’s syndrome than anti-SSA, leading to some ambiguity in diagnosis.

A seventeen year old female patient presented with a large, soft, sublingual cyst on the left side of the floor of her mouth. While she reported no pain, the cyst was first spotted about a year earlier, and had been growing steadily. Visible swelling was observed on the left side of her face under her jaw line. Surgery was performed to remove the cyst, and an adjacent salivary gland was removed as well. The otorhinolaryngologist took a tissue sample, and histology confirmed a benign growth. The surgeon ordered a blood panel to evaluate antibody levels that might indicate an autoimmune disease. The patient’s serum was negative for rheumatoid factor, anti-SSB antibodies, and anti-nuclear antibodies. However, she was positive for anti-SSA antibodies, with a level of 50 U/ml. Bacterial cultures were negative for oral infection, and an X-ray was negative for sarcoidosis. Patient was discharged after surgery with no medications indicated, as she was not experiencing any other symptoms.

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