Patients with Sjögren disease and lymphoid interstitial pneumonia may present with a distinct clinical phenotype and preserved pulmonary function.

Evidence supporting central nervous system outcomes in Sjögren disease is limited.

Elevated levels of interferon-α may drive an immunological endotype of Sjögren disease, and could offer a novel treatment target for the condition.

Salivary flow tests can identify distinct patterns of glandular dysfunction in patients with Sjögren disease.

Emerging therapies are reshaping the landscape of treatment options for Sjögren’s disease.

A combination of leflunomide and hydroxychloroquine may reduce systemic disease activity in active Sjögren disease.

Ultra-high frequency ultrasound of the labial salivary glands may accurately classify Sjögren disease and reduce the need for biopsy.

Objective Sjögren disease (SjD) is a systemic autoimmune condition that frequently involves the salivary glands. Salivary gland ultrasound (SGUS) has emerged as a promising noninvasive tool, and the Outcome Measures in Rheumatology (OMERACT) group has proposed a standardized semiquantitative scoring system. The aim of this study was to evaluate the diagnostic accuracy of OMERACT SGUS in routine clinical practice, using the 2016 American College of Rheumatology/European Alliance of Associations for Rheumatology (ACR/EULAR) criteria as the gold standard for diagnosis, and to compare its performance with salivary flow and Schirmer test. Methods A prospective study was conducted including 103 consecutive outpatients referred for dryness evaluation. Two blinded sonographers performed SGUS of parotid glands (PGs) and submandibular glands (SMGs), applying the OMERACT 0-3 scale. Positivity was defined as a score ≥ 2 in at least 1 gland. Results Among 103 participants, 51 fulfilled the 2016 ACR/EULAR criteria. Overall, SGUS achieved sensitivity of 66.7% and specificity of 76.9%. PG analysis showed high specificity (92.3%) but lower sensitivity (49%), whereas SMGs demonstrated higher sensitivity (58.8%) but lower specificity (78.8%). Schirmer test and unstimulated whole salivary flow rate (UWSFR) showed sensitivities of 49% and 52.9%, respectively. Stimulated whole salivary flow rate had very high specificity (94.2%) but poor sensitivity (17.6%). In patients aged < 40 years, UWSFR sensitivity dropped markedly to 20% (vs age ≥ 40 years: 57.1%), whereas SGUS maintained stable performance. Conclusion In real-world settings, SGUS using the OMERACT score demonstrates high specificity, particularly in PGs, and moderate sensitivity, outperforming UWSFR in younger patients. These findings support SGUS as a practical adjunct to established diagnostic tests and reinforce its potential role in refining the diagnostic workup of suspected SjD.

A rare overlap between Sjögren disease and TAFRO syndrome, which is a hyperinflammatory disorder. Treatment with the IL-6 inhibitor tocilizumab led to rapid improvement in this patient.