Increased SE

70–80

Leukopenia

10–30

Thrombocytopenia

10

Rheumatoid factor

80–90

Hypergammaglobulinemia

80

ANA

80–90

Anti-Ro by ELISA method

85–95

By gel precipitation

40–60

Anti-La by ELISA method

70–85

By gel precipitation

25–40

ACLA

15

AMA

5

ASMA

30

Anti-TPO

25

I. Ocular symptoms – a positive response to at least one of the following questions:

 Have you had daily, persistent, troublesome dry eyes for more than 3 months?

 Do you have a recurrent sensation of sand or gravel in the eyes?

 Do you use tear substitutes more than 3 times a day?

II. Oral symptoms – a positive response to at least one of the following questions:

 Have you had a daily feeling of dry mouth for more than 3 months?

 Have you had recurrently or persistently swollen salivary glands as an adult?

 Do you frequently drink liquids to aid in swallowing dry food?

III. Ocular signs – that is, objective evidence of ocular involvement defined as positivity for at least one of the following two tests:

 Schirmer’s I test, performed without anesthesia (<5 mm in 5 min)

 Rose bengal score or other ocular dye scores (>4 according to van Bijsterveld’s scoring system)

IV. Histopathology: In minor salivary glands (obtained from normal-appearing mucosa) focal lymphocytic sialadenitis, evaluated by an expert histopathologist, with a focus score >1, defined as a number of lymphocytic foci (which are adjacent to normal-appearing mucous acini and contain more than 50 lymphocytes) per 4 mm [2] of glandular tissue