21 - Sjögren's syndrome Flashcards
What is Sicca syndrome?
Partial sjogren’s findings
What is primary Sjögren’s syndrome?
No connective tissue disease
What is secondary Sjögren’s syndrome?
- connective tissue disease
- associated with SLE, RA adn scleroderma
Who is most likely to present with Sjögren’s syndrome?
Women 10:1
What systemic involvement is associated with Sjögren’s syndrome?
- lungs
- kidney
- liver
- pancreas
- blood vessels
- nervous system
- general fatigue and chronic pain
How is Sjögren’s syndrome diagnosed?
- no single test
- relies on balance of probabilities of multiple criteria
- commonly used is the American- European consensus group
What tests are required as part of the AECG criteria for a diagnosis of Sjögren’s syndrome?
- dry eyes or mouth (subjective or objective)
- autoantibody findings
- US imaging
- radio nucleotide findings
- histopathology findings (labial gland biopsy)
How does Sjögren’s syndrome appear in imaging?
Snowstorm or leopard spot appearance
What oral symptoms indicate Sjögren’s syndrome?
- daily feeling of dry mouth for >3 months
- recurrent swelling of salivary glands as adult
- frequently sip liquid to aid swallowing
What ocular symptoms indicate Sjögren’s syndrome?
- persistent troublesome dry eyes for >3 months
- recurrent sensation of sand in eyes
- tear substitutes used >3 times daily
What are the tests used for dry eyes?
- Schirmer test (paper in eye)
- fluorescein tear film assessment
What tests are used for dry mouth?
Unstimulated whole salivary flow (UWS)
What does a positive antibody finding indicate?
- not a causative factor
- antibodies are associated with the clinical pattern when the disease presents
- antibodies can be present without disease
What is a lymphocytic focus?
- > 50 lymphocytes around a duct in a labial gland biopsy
- more than 1 focus site indicates Sjögren’s syndrome
How do you manage a patient with Sjögren’s syndrome who presents late?
- symptomatic relief of oral symptoms
- salivary stimulants (pilocarpine)
- OHI ++
