Sjogren’s Syndrome

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!

 

Sjogren 1

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

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