Embarrassed by the visible gland swelling
Avoids some of her favorite foods due to salivary gland swelling
Has experienced a negative impact on intimacy due to vaginal dryness symptoms
Have you had any vaginal infections or UTIs lately?
What are some things you used to do easily that are now more difficult?
How often have you had swelling in your salivary glands? How many episodes? Any persistent swelling or nodular changes?
Have you been experiencing any new difficulty with speaking or singing?
Have you been having night sweats or any unexplained weight loss?
Have you noticed any rashes or red or purple spots on your skin?
Have you noticed any shortness of breath with mild exertion (eg, walking around the block) or a persistent cough?
Have you noticed any swelling of lymph nodes in your neck, armpits, groin, or behind your ears?
Have you been feeling any tingling, numbness, or pain in your hands or feet? Any trouble holding or opening objects?
Have you had any joint stiffness in the morning or trouble climbing stairs or standing up from a chair? Any muscle pain?
Have you been experiencing any brain fog or difficulty with concentration?

“To ensure her disease is being adequately evaluated, I would order additional lab tests for CMP, urinalysis, CRP/ESR, SPEP, cryoglobulins, rheumatoid factor, anti-SSB, free light chains, Kappa and Lambda with ratio, beta-2 microglobulin, and CPK.”
Ghaith Noaiseh, MD
ANA, antinuclear antibody; ANC, absolute neutrophil count; CBC, complete blood count; CMP, comprehensive metabolic panel; CPK, creatine phosphokinase; CRP, C-reactive protein; ENT, ear, nose, and throat doctor; ESR, erythrocyte sedimentation rate; HBV, hepatitis B virus; HCV, hepatitis C virus; IgG, immunoglobulin G; SPEP, serum protein electrophoresis; SSA, Sjögren's syndrome type A; SSB, Sjögren's syndrome type B; UTI, urinary tract infection; UWSFR, unstimulated whole salivary flow rate.

