Ripsman DA, Bookman A, et al. - It is crucial that practicing specialists perform objective testing of all patients suspected of primary Sjögren syndrome (pSS), instead of relying on symptoms, although objective measures of xerostomia may not be practical for general population screening. The physician cannot ensure the diagnosis of pSS without objective testing and that the existence of significant damage is not overlooked and left untreated.

• Researchers performed a cross-sectional analysis of pre-screened pSS and sicca control patients evaluated in the Multidisciplinary Sjögren’s Clinic at the University Health Network in Toronto.

• They prospectively recorded signs, symptoms, and objective measures of oral and ocular dryness and damage of each patient using a standardized protocol.

• It was shown that subjective measures of severity for xerophthalmia and xerostomia are associated in general with objective severity.

• Compared with ocular symptoms, oral symptoms tend to have a stronger association with objective findings.

• They observed that many individuals with few or insignificant eye symptoms had profound ocular dryness and damage.

• Similarly, some individuals with few or no symptoms of oral dryness had profound objective salivary hypofunction.

• It demonstrates that the absence of symptoms does not rule out a profound eye and mouth dryness or damage.