• Sjøgren's Syndrome
• Inflammation
• Epidemiology
• Health services research

Although only a small number of rheumatologists participate in clinical trials of Sjogren's syndrome (SS), the majority of rheumatologists need to assess the new criteria for SS in their clinical practice. We need to know how to obtain and evaluate the minor labial salivary gland (LSG) biopsy. We are increasingly asked to make critical therapeutic decisions about treatment of life-threatening clinical situations that might be due to SS, so uniform criteria for correct diagnosis are increasingly important.

Fisher et al 1 present an expert consensus for ‘standardisation of LSG’ histopathology in clinical trials in primary SS in this issue.

Rheumatologists are aware that a ‘new’ consensus criteria between the American College of Rheumatology and European League Against Rheumatism were recently approved.2 However, it is less well recognised that SS diagnosis is now based on a ‘point system’, and that four points are required for diagnosis of SS.

• A positive labial salivary biopsy (LSB) only qualifies for three points (table 1). Thus, a positive LSB will not fulfil criteria alone.

• Similarly, a positive antibody to Sjogren's Syndrome A (SS-A) only counts for three points, and alone, will not fill criteria.

Thus, the basis for diagnosis and treatment of our most difficult patients, such …