Some people with Sjogren's syndrome will have evidence of sarcoidosis. There is controversy whether the two are independent, can occur as an overlap syndrome, or just a form of sarcoidosis.
Presentation: xerostomia (dry mouth) and xerophthalmia (dry eye)
Problems in diagnosis tend to occur when the person presents with dry mouth and dry eye prior to diagnosis of sarcoidosis. It is less of an issue if the person has an established history of sarcoidosis prior to symptom onset.
In patients with sarcoidosis there will be:
(1) noncaseating granulomas in salivary gland biopsies
(2) variable presence of systemic signs of sarcoidosis (hilar lymphadenopathy, arthritis, etc)
In patients with primary Sjogren's syndrome will have antibodies to either anti-SSA/Ro or anti-SSB/La.
Other causes of secondary Sjogren's syndrome (medications, viral hepatitis C, etc) and noncaseating granulomas need to be excluded.
Finding
Sarcoid Only
Overlap
Primary Sjogren's
granulomas
present
present
absent
antibodies
absent
present
present
systemic sarcoid
present
present
absent
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