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Is a lip biopsy necessary to diagnose Sjogren's when blood work has antibodies?

Hi guys! I read a bunch of other post, and it seems you are all a wealth of knowledge and helpfulness, so I hope you don't mind me running this past you.

According to my rheumatologist, I have a high titre of SS-A and a fairly high SS-B. I think my eyes and mouth are dry (my eyes itch, and I get mouth sores of no known origin), but I don't have much to compare it to. My more pressing symptoms are joint pain, headache, neck ache, sinus problems, and a weird thing that happened last winter where I simultaneously had digestive issues, racing heart (resting was often over 130), and a rash. I'm pretty sure I've had parotid swelling in the past, but my doctor at the time labeled it TMJ. I also have an underactive thyroid that appears to be a result of Hashimoto's (based on blood work).

My rheumatologist referred me to an oral surgeon to do a lip biopsy. I set up the appointment, prepared myself mentally, gathered supplies for recovery, had someone else drive me, and went in to his office an hour away...and it turned out to just be a consultation. The doctor repeated what my rheumatologist had already told me and set up another appointment for the actual biopsy.

Needless to say, the whole experience psyched me out, and now I really don't want to go through all the prep and stress again. Given all this, I'm wondering if a lip biopsy is really necessary anyway, or if a Schirmer's test wouldn't be enough. What happens if I opt out of the lip biopsy?

Also, I love my rheumatologist and certainly don't want to insult him. Do docs get upset or offended if you don't do all the tests they think should be done?

Thanks for your help! This is uncharted waters for me, and I really don't know what to do.
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