A 49-year-old woman is diagnosed with Sjogren syndrome following complaints of a foreign body sensation in her eyes and a dry mouth. Which one of the following is NOT characteristic of Sjogren syndrome?

Choice A reason: Sjogren syndrome is associated with an increased risk of developing non-Hodgkin’s lymphoma, particularly B-cell lymphomas, due to chronic autoimmune stimulation of lymphoid tissue. This is a recognized characteristic of the disease. Choice B reason: The condition disproportionately affects females, with a female-to-male ratio of approximately 9:1. This is a well-established epidemiologic feature of Sjogren syndrome. Choice C reason: Sjogren syndrome occurs worldwide and is not significantly more prevalent in White populations in North America compared to other regions. Suggesting a strong racial or geographic predilection is inaccurate, making this the correct answer to the question. Choice D reason: Minor salivary gland biopsy is the gold standard diagnostic test for confirming Sjogren syndrome. The presence of focal lymphocytic sialadenitis supports the diagnosis and is considered an essential diagnostic tool.