Sjögren’s antibodies include anti-SS-A (also called anti-Ro) and anti-SS-B (also called anti-La). These antibody levels can be measured in the blood. 

Anti-SS-A and anti-SS-B are considered autoantibodies. They contribute to disease by attacking the body’s own tissue. Elevated levels of these autoantibodies are strongly associated with Sjögren’s syndrome, in which they attack healthy glands that make tears and saliva, but they can also be present in several other autoimmune conditions.

Purpose of the Test

Sjögren’s antibody levels are measured as part of the diagnostic evaluation of symptoms that could be associated with this and other autoimmune conditions. These antibody levels may also be measured to assess the risk of heart disease in people who have autoimmune diseases.

Typically, interpretation of elevated levels of anti-SS-A and anti-SS-B antibodies is made with consideration of other tests, including other inflammatory markers in the blood.

Sometimes, Sjögren’s antibody testing is indicated for people who are pregnant and have an autoimmune disease because elevated levels are associated with newborn heart disease and neonatal lupus.

Symptoms that might indicate a need for Sjögren’s antibody testing include:

  • Dry eyesDry mouth Joint stiffness or joint pain Fatigue Joint swelling Skin redness Systemic disease, including kidney failure, gastrointestinal (GI) symptoms, and thyroid disease

What Are Sjögren’s Antibodies?

SS-A/Ro proteins are made by cells in the body and can be found on cell surfaces and inside the cells. SS-B/La proteins are found inside cells of the body. These proteins normally bind to ribonucleic acid (RNA), which plays an important role in the body’s production of proteins.

Antibodies are immune proteins produced by B-white blood cells (a type of immune cell) to help the body fight against infections. There are several types of antibodies, and IgG antibodies are associated with chronic (long-term) disease or long-term response to an infection.

Normally, the body has minimal or undetectable levels of antibodies against the Ro and La proteins, but IgG antibodies to these proteins can develop in some conditions. Elevated anti-SS-A antibodies and/or anti-SS-B antibodies indicate inflammatory connective tissue disease, especially Sjögren’s syndrome. 

Your healthcare provider might order these tests for you if there is a concern that you could have:

  • Sjögren’s syndrome
  • Systemic lupus erythematosus (SLE)
  • Rheumatoid arthritis
  • Vasculitis (inflammation of the blood vessels)
  • Autoimmune hepatitis
  • Autoimmune disease during pregnancy
  • Lung disease
  • Myositis

Risks and Contraindications

There are no health contraindications to (reasons against) having Sjögren’s antibody testing. The test is a blood test with minimal risks.

There is a small risk of bruising, persistent or excessive bleeding, or an infection from the needle puncture. The risk of bruising or bleeding is higher if you have a bleeding disorder or if you take blood thinners. An infection can be prevented by keeping the puncture site covered and clean for one day after your test.

Before the Test

Your healthcare provider will take your medical history and do a physical examination. If there is a concern that you could have Sjögren’s syndrome or another autoimmune connective tissue disorder with inflammation, you might need to have this test.

Timing 

You should devote approximately one hour for your antibody test and the registration and pretesting process, but the blood test procedure itself should take only about 10 minutes.

Location

You will likely have this test as an outpatient. It may be done in your healthcare provider’s office during your appointment, or you might need to go to a clinic or lab to have your blood drawn.

What to Wear

You can wear anything comfortable to your appointment. Make sure you can roll up your sleeves for access to your antecubital area (the part of your inner arm at the level of your elbow).

If you want to cover your bandage after your test, you can wear a loose jacket or a loose long-sleeved shirt.

Food and Drink 

You do not need to modify your food or drink intake before or after this test. However, if you are having other tests drawn at the same time, they may have restrictions, so check with your healthcare provider’s instructions.

Cost and Health Insurance

The cost of this test varies and can range between $200 to $500. Typically, other tests are ordered with Sjögren’s antibody tests, and they would have an additional cost. Many health insurance plans cover the full or partial cost of Sjögren’s antibody testing done for a clinical indication.

What to Bring

When you go to your test appointment, you will need to have your test order form, identification, and health insurance information. You do not need to make any special transportation arrangements—you can drive after this test if you normally drive.

During the Test

When you go to your test appointment, you will need to register and sign a consent form. You will go to the area where your blood will be drawn, and you might have your vital signs checked—temperature, breathing rate, pulse, and blood pressure.

Throughout the Test

You will sit for your test, and you will likely be asked from which arm you would like to have your blood drawn. You will rest your arm, roll up your sleeves above your elbows, and the nurse or phlebotomist will cleanse your skin where the needle will be inserted.

You will have an elastic band wrapped around your upper arm, and a needle will be inserted into a vein to collect the blood into a tube. The needle will remain in place for several seconds while the tubes are filled. If you are having several tests, more than one tube may be filled.

The band will be removed, followed by the needle. For a few minutes after the test, you may be asked to place pressure with a cotton ball on the area where the needle was inserted until the bleeding stops.

You will have a bandage placed on the area, and you might have gauze wrapped around as well. You may be given additional bandages, and you will be instructed to keep the puncture site covered for a period of time after your test.

Post Test

After the blood draw, you may be asked to stay for a few minutes and confirm that you feel well. If you feel lightheaded, your nurse may check your vitals, and you might be given water or juice until you feel better. And if you continue to feel sick, you will be evaluated by a healthcare provider.

After the Test 

You should be able to resume your normal activities after your test. You might be instructed to avoid heavy lifting with the arm in which you had the needle puncture for one day after your blood test. You can bathe, shower, and swim after your test.

If you didn’t experience any bruising or blood leakage, the bandage may be removed after an hour or two. Follow the advice of the phlebotomist or nurse if you had a difficult draw with bruising or extended bleeding.

Managing Side Effects

You may develop a painless bruise near the puncture site. This should get better within a week. If you experience persistent bleeding, a fever, pain, redness, swelling, or oozing near your puncture site, call your healthcare provider or get urgent medical attention.

Interpreting Results 

You will likely have a follow-up appointment with your healthcare provider to discuss your results.

About 50% of patients with Sjögren’s syndrome have autoantibodies in their blood. The presence of antibodies can help differentiate primary Sjögren’s syndrome from secondary Sjögren’s syndrome (which occurs secondary to another autoimmune condition).

Anti-SS-A antibodies are more common than anti-SS-B antibodies. Anti-SS-B antibody is more specific for Sjögren’s syndrome, and anti-SS-A antibody is more likely with other autoimmune conditions, such as SLE and rheumatoid arthritis.  

Anti-SS-A antibodies can be present in QT prolongation arrhythmia, and its presence may suggest that a person is predisposed to ventricular arrhythmias or sudden cardiac death. In some instances, further cardiac evaluation and treatment may be needed to prevent complications.

Autoimmune congenital heart block (CHB) occurs in 2% of children exposed to anti-Ro/SS-A before their birth. The recurrence rate is nine times higher in subsequent pregnancies. Mothers of babies at risk for this heart defect might be treated with medication during pregnancy to prevent the condition.

Follow-Up

You might need to have additional testing or follow-up testing. If you have been treated for a connective tissue disease, your Sjögren’s antibody test results might change, but this is not necessarily used as a guide for treatment. Typically, symptoms are the guide for modifying treatment, rather than Sjögren’s antibody test results.

A Word From Verywell 

A number of inflammatory conditions can cause an increase in Sjögren’s antibodies. These tests are used in combination with a medical history, clinical examination, and other diagnostic tests to help guide the diagnosis and determine the best treatment course for your condition.

Frequently Asked Questions

  • What are SSA and SSB antibodies?
  • Anti-SS-A and anti-SS-B are autoantibodies that are associated with Sjögren’s syndrome. Anti-SSA and anti-SSB antibodies attack healthy glands that produce tears and saliva and can be present in several autoimmune conditions.
  • What does it mean to have elevated Sjögren’s antibodies?
  • Elevated Sjögren’s antibodies—anti-SS-A and anti-SS-B—are suggestive of inflammatory connective tissue disease. Elevated results on this test may indicate Sjögren’s syndrome or another autoimmune disease such as lupus or rheumatoid arthritis.
  • Is Sjögren’s syndrome a type of lupus?
  • No, but there is a lot of overlap between the two conditions. Up to 18% of people with lupus also have Sjögren’s syndrome. Sjögren’s syndrome also commonly co-occurs in people with rheumatoid arthritis.

Anti-SS-A and anti-SS-B are autoantibodies that are associated with Sjögren’s syndrome. Anti-SSA and anti-SSB antibodies attack healthy glands that produce tears and saliva and can be present in several autoimmune conditions. 

Elevated Sjögren’s antibodies—anti-SS-A and anti-SS-B—are suggestive of inflammatory connective tissue disease. Elevated results on this test may indicate Sjögren’s syndrome or another autoimmune disease such as lupus or rheumatoid arthritis.

No, but there is a lot of overlap between the two conditions. Up to 18% of people with lupus also have Sjögren’s syndrome. Sjögren’s syndrome also commonly co-occurs in people with rheumatoid arthritis.