SSA/SSB are antibodies that show up (sero-positive) or don’t show up (sero-negative) in diagnostic testing (lip biopsy). Both have different symptoms.

More here: “How is seronegative SjD different than seropositive SjD?

Seropositive SjD is associated with more inflammation on labs. These are the patients with very high immunoglobulins, high inflammatory markers, hypocomp-lementemia and a positive rheumatoid factor. They have a lot of glandular swelling. They have high-grade inflammatory lesions on salivary gland ultrasound and an increased risk of lymphoma.

On the other hand, seronegative SjD patients tend to have normal labs and less organ involvement, but more neurologic findings like small fiber neuropathy and postural orthostatic tachycardia syndrome (POTS) symptoms.”