Definition:
Idiopathic autoimmune disorder secondary to antibodies predominantly against lacrimal and salivary glands
Associated w\:
RA, SLE, primary biliary cirrhosis, polymyositis, hashimoto thyroiditis
Presentation:
- Dry eyes (keratoconjunctivitis sicca): burning, redness, blurred vision, itching, “sand in eyes” feeling
- Dry mouth and tooth decay
- Dyspareunia? Loss of vaginal secretions
- Arthralgia, arthritis, fatigue
- Vasculitis, interstitial nephritis, renal tubular acidosis
- Most dangerous complication? Lymphoma!
Diagnosis:
- Schrimer test -> placing filter paper against the eye to measure lacrimal gland output
- Rose Bengal stain of the eyes -> small ulcerations
- Anti-Ro (SS-A) and Anti-La (SS-B)
- Most accurate: lip or parotid gland biopsy
Treatment:
- Water the mouth, fluoride, artificial tears
- Pilocarpire or Cevimeline -> increase Ach -> stimulate ocular and salivary secretions
Download the PDF version: here
References:
- Step up to medicine
- Pocket medicine
- Toronto notes
