Screenings if you have Sjögren's disease
Sjögren's disease (also called Sjögren's syndrome) is an autoimmune condition in which the glands that make tears and saliva are damaged, causing dry eyes and a dry mouth. It can also affect other parts of the body, including the kidneys and lungs, and occurs most often in women ages 40 to 50. (MedlinePlus) This page covers the regular checks guidance lists for adults with Sjögren's disease, not treatment.
The main guidance
The British Society for Rheumatology (BSR) published an updated guideline in 2024 that builds on its first guideline from 2017. It says features outside the eyes and mouth affect at least 70 percent of people and include lung disease (interstitial lung disease, ILD) and B-cell lymphoma, with a 5 to 10 percent lifetime risk of lymphoma. (BSR guideline, 2024) In the US, the Sjögren's Foundation developed the first US clinical practice guidelines for oral, eye and rheumatology care, summarized in 2016. (Sjögren's Foundation guidelines, 2016) Two lung guidelines include Sjögren's disease: the 2023 ACR/CHEST guideline on screening and monitoring for ILD (ACR/CHEST lung guideline, 2023) and the 2026 ERS/EULAR guideline on connective tissue disease-associated ILD. (ERS/EULAR lung guideline, 2026)
Sjögren's disease can occur on its own or together with another autoimmune condition such as rheumatoid arthritis, lupus or scleroderma. (MedlinePlus) The BSR guideline says all confirmed conditions should be taken into account when planning tests. (BSR guideline, 2024) See screenings if you have rheumatoid arthritis or lupus and screenings if you have systemic sclerosis.
Tests and checks the guidance lists
| Check | Looks for | How often | Source |
|---|---|---|---|
| Thyroid, liver, coeliac (TTG), immunoglobulins and serum electrophoresis, bicarbonate, creatine kinase, vitamin D | Linked conditions such as thyroid disease, coeliac disease, monoclonal gammopathy and kidney acid problems | At the start, then as needed | (BSR guideline, 2024) |
| Complement (C3, C4), cryoglobulins, blood count, antibodies | Lymphoma risk and risk of wider disease | At the start (baseline assessment) | (BSR guideline, 2024) |
| Lung function tests and high-resolution chest CT | Interstitial lung disease | For people at higher risk; with lung disease, lung function yearly (BSR) or every 3 to 12 months in the first year (ACR/CHEST) | (ACR/CHEST lung guideline, 2023)(ERS/EULAR lung guideline, 2026)(BSR guideline, 2024) |
| Dental check-up | Tooth decay and gum disease | Every 6 months | (NHS) |
| Eye check | Dry eye damage | Regularly | (NHS) |
| Rheumatology follow-up | Changes in the disease | Set case by case | (BSR guideline, 2024) |
Blood tests at the start
The 2024 BSR guideline says the first assessment should include a thorough clinical and blood antibody check to judge the risk of the disease spreading beyond the glands. It lists anti-Ro antibodies, a positive rheumatoid factor, a younger age at onset, Black or African American ethnicity and male sex as linked with a higher risk. (BSR guideline, 2024) It recommends testing thyroid function, liver function (with anti-mitochondrial antibodies if indicated), TTG for coeliac disease, immunoglobulins with serum electrophoresis, serum bicarbonate, creatine kinase and vitamin D at the start, and repeating them as clinically indicated. It reports thyroid disease in 22 percent of people in one large series and says coeliac disease is about 10 times more common than in the general population. (BSR guideline, 2024) MedlinePlus lists a blood count, urinalysis, complement levels, cryoglobulins and protein electrophoresis among the tests that may be done. (MedlinePlus) See thyroid test results, celiac disease screening, liver function test results and complete blood count results.
Lymphoma risk markers and warning signs
The 2024 BSR guideline says the most consistent markers of a higher future lymphoma risk are low complement C3 or C4 (low C4 the strongest), salivary gland enlargement, swollen lymph nodes, cryoglobulins in the blood, a monoclonal gammopathy (an abnormal antibody protein) and a high focus score on a lip biopsy (above 4). It says warning signs of early lymphoma include persistent night sweats, fevers, weight loss of 10 percent or more over the past 3 months and an enlarged spleen, and that people with new salivary gland swelling or symptoms that might suggest lymphoma should be offered further tests early. (BSR guideline, 2024) It reports a monoclonal gammopathy in 22 percent of one European group of 221 people with Sjögren's disease. (BSR guideline, 2024) MedlinePlus says the lymphoma risk is higher when the disease has been very active for a long time and in people with vasculitis, low complement levels and cryoglobulins. (MedlinePlus)
Lung checks
The 2023 ACR/CHEST guideline lists Sjögren's disease among the conditions with a higher risk of interstitial lung disease, with anti-Ro52 antibodies, a positive ANA, Raynaud phenomenon, older age, a low lymphocyte count and severe tooth decay as risk factors. For people at higher risk it suggests screening with lung function tests (spirometry, lung volumes and DLCO) together with a high-resolution chest CT, and not with a chest X-ray. For people with Sjögren's-related ILD it suggests lung function tests every 3 to 12 months for the first year, then less often once stable. (ACR/CHEST lung guideline, 2023) The 2026 ERS/EULAR guideline suggests that people with Sjögren's disease and risk factors (older age, male sex, active disease in other organs and raised inflammation markers) could be screened for ILD with a high-resolution CT, and recommends against replacing CT with lung function tests for screening. (ERS/EULAR lung guideline, 2026) The BSR guideline says lung function tests should be done every year, or sooner if needed, for people with known lung disease. (BSR guideline, 2024)
Kidney checks
The 2024 BSR guideline says distal renal tubular acidosis, a kidney problem with handling acid, is linked with Sjögren's disease: about 5 percent have the complete form and 25 percent an incomplete form. A low serum bicarbonate fits the complete form; the incomplete form may need more complex testing. (BSR guideline, 2024) MedlinePlus lists kidney failure as a rare complication and urinalysis among the tests that may be done. (MedlinePlus) See kidney test results.
Eye and dental checks
The NHS advises dental check-ups every 6 months and regular eye checks for people with Sjögren's syndrome. (NHS) The Sjögren's Foundation guideline summary says people with Sjögren's disease have significantly more tooth decay and tooth loss than people without it, (Sjögren's Foundation guidelines, 2016) and the BSR guideline recommends proactive dental care. (BSR guideline, 2024) MedlinePlus lists an eye examination by an ophthalmologist and a Schirmer test of tear production among the tests that may be done. (MedlinePlus) See eye exams by age.
Heart risk
The 2024 BSR guideline notes that high blood pressure is one of the most common other conditions in Sjögren's disease and points to EULAR advice to use standard risk tools and manage blood pressure and cholesterol as for the general population. (BSR guideline, 2024) See blood pressure readings and cholesterol tests by age.
When to contact a provider
MedlinePlus, Sjogren syndrome, when to contact a medical professional: (MedlinePlus)
Contact your provider if you develop symptoms of Sjögren syndrome.
Routine age-based screening
These checks are added to, not instead of, the routine screenings for your age and sex; see screenings by age and gender. The BSR guideline says the frequency of follow-up should be decided case by case, based on how long you have had the condition, the number of lymphoma risk factors, any disease outside the glands and any immune-suppressing treatment. (BSR guideline, 2024)
Where they differ:
- Which lung test to screen with. The 2023 ACR/CHEST guideline suggests lung function tests together with a high-resolution CT for people at higher risk; the 2026 ERS/EULAR guideline puts CT first and recommends against using lung function tests in place of CT. (ACR/CHEST lung guideline, 2023)(ERS/EULAR lung guideline, 2026)
- Who counts as higher risk for lung disease. ACR/CHEST lists anti-Ro52 antibodies, ANA, Raynaud phenomenon, older age, a low lymphocyte count and severe tooth decay; ERS/EULAR lists older age, male sex, active disease in other organs and raised inflammation markers. (ACR/CHEST lung guideline, 2023)(ERS/EULAR lung guideline, 2026)
- How often lung function is checked with lung disease. BSR says every year or sooner if needed; ACR/CHEST suggests every 3 to 12 months in the first year, then less often once stable. (BSR guideline, 2024)(ACR/CHEST lung guideline, 2023)
- Fixed schedules. The NHS gives a 6-monthly dental check-up; the BSR guideline says there is poor agreement on how often follow-up should be and leaves it case by case. (NHS)(BSR guideline, 2024)
Your doctor decides what your result means for you.
Questions people ask
Is there a screening test for Sjögren's disease if I have no symptoms?
No. The 2024 BSR guideline says the ANA blood test should not be measured without clinical signs of Sjögren's disease or another connective tissue disease; it is used as a first test when one is suspected. (BSR guideline, 2024)
Which blood tests are done after diagnosis?
The 2024 BSR guideline recommends checking thyroid function, liver function, a coeliac antibody test (TTG), immunoglobulins with serum electrophoresis, serum bicarbonate, creatine kinase and vitamin D at the start, then repeating them as needed. (BSR guideline, 2024)
What are the warning signs of lymphoma?
The 2024 BSR guideline lists new salivary gland swelling, swollen lymph nodes, persistent night sweats, fevers, weight loss of 10 percent or more over 3 months and an enlarged spleen. It says people with new swelling or such symptoms should be offered further tests early. (BSR guideline, 2024)
Do I need a lung scan?
The 2023 ACR/CHEST guideline suggests lung function tests and a high-resolution CT scan for people with Sjögren's disease at higher risk of lung disease, and not a chest X-ray. The 2026 ERS/EULAR guideline suggests a CT scan could be used for those with risk factors. (ACR/CHEST lung guideline, 2023) (ERS/EULAR lung guideline, 2026)
How often should I see a dentist?
The NHS says people with Sjögren's syndrome should have dental check-ups every 6 months and regular eye checks. (NHS)