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Sjögren's syndrome is an important differential diagnosis in patients with sensory neuronopathy because immunosuppressive therapy may prevent progressive degeneration of sensory fibres, ganglions and axons. Due to the challenges in the diagnostic process the diagnostic criteria have repeatedly changed over the past few years. In patients with negative antibodies (SSA, SSB antibodies) biopsy of the salivary glands of the lip and the parotid gland can be useful to diagnose Sjögren's syndrome. We report on four patients in whom biopsy of the salivary gland was helpful in establishing the diagnosis of Sjögren's syndrome and consequently immunosuppressive therapy was initiated. One of these patients suffered from hypersalivation. This was probably due to denervation hypersensitivity. To our knowledge this has not been reported yet.