title: Xerophthalmia of Sjogren's Syndrome Diagnosed with Anti-Salivary Gland Protein 1 Antibodies.
abstract: OBJECTIVE
  The purpose of this report is to describe 2 patients with persistent severe dry eyes, positive Schirmer tests for Sjogren's syndrome (SS) but lacking antibodies to either Ro or La. These patients were diagnosed to have SS by detecting antibodies to salivary gland protein 1 (Sp1) and parotid secretory protein (PSP). This report emphasizes the existence of patients with SS who lack antibodies to either Ro or La and may therefore be misdiagnosed. Detection of novel autoantibodies, including antibodies to Sp1 and PSP, are helpful in identifying these patients. Initial presentation may simply be dry eyes.
  
  
  METHODS
  Two patients who presented to our ophthalmology clinic are described. One of the patients underwent multiple procedures over a period of 10 years for severe xerophthalmia. The other patient had rheumatoid arthritis and xerophthalmia. However, in both patients, chronic xerophthalmia had been considered to be idiopathic because antibodies Ro and La were negative. Further serologic testing revealed antibodies to Sp1 and PSP.
  
  
  RESULTS
  Two patients who lacked antibodies to Ro and La but not to Sp1 and PSP were diagnosed as having SS.
  
  
  CONCLUSIONS
  Patients presenting with unexplained dry eyes may not always show the serology markers in the current criteria for SS, anti-Ro and anti-La. In these cases, investigation for novel, early antibodies to Sp1 and PSP is of importance in the diagnosis of SS.
authors: SUNY at Buffalo School of Medicine, SUNY at Buffalo School of Dental Medicine, Buffalo, N.Y., USA.
authors: Sahana
authors: S
authors: Vishwanath
authors: SUNY at Buffalo School of Medicine, SUNY at Buffalo School of Dental Medicine, Buffalo, N.Y., USA.
authors: Sandra
authors: S
authors: Everett
authors: SUNY at Buffalo School of Medicine, SUNY at Buffalo School of Dental Medicine, Buffalo, N.Y., USA.
authors: Long
authors: L
authors: Shen
authors: SUNY at Buffalo School of Medicine, SUNY at Buffalo School of Dental Medicine, Buffalo, N.Y., USA ; Immco Diagnostics, Buffalo, N.Y., USA.
authors: Kishore
authors: K
authors: Malyavantham
authors: Department of Oral Diagnostic Sciences, SUNY at Buffalo School of Dental Medicine, Buffalo, N.Y., USA ; Immco Diagnostics, Buffalo, N.Y., USA.
authors: Lakshmanan
authors: L
authors: Suresh
authors: SUNY at Buffalo School of Medicine, SUNY at Buffalo School of Dental Medicine, Buffalo, N.Y., USA.
authors: Julian L
authors: JL
authors: Ambrus
keywords: Autoantibodies; Sjogren's syndrome; Xerophthalmia