Connective Tissue Diseases: Sjogren's Syndrome Flashcards
sjogrens syndrome
- chronic inflammatory disorder characterised by lymphoctic infiltrates in exocrine organs
- typically causes diminshed lacrimal and salivary gland function resulting in dry eyes and dry mouth
primary or secondary
- either
- often 2y to autoimmune conditions eg RA and SLE
who is it most common in
women in 50s and 60s
primary clinical features
caused by lymphocytic infiltration of the lacrimal and salivary glands resulting in dry eyes (keratconjuncitivits sicca) and mouth (xerostomia), also dry throat
clinical features
- fatigue
- vaginal dryness
- bilateral parotid gland enlargement
- joint pains
- Raynauds
what is seen in the mouth
increase in dental caries and gum inflammation
what is seen in the joints
arthralgia - pain
what is seen in the kidney
- chronic tubulointerstitial nephritis is the most common renal manifestation
what is there an inc risk of
lymphoma
what else may occur
peripheral neuropathy and ILD
diagnosis
- confirmation of occular dryness - Schirmers test
- positive anti Ro and La antibodies
- typical features on a lip gland biopsy
schirmer’s test
- Filter paper is placed near conjunctival sac to measure tear formation
management
largely symptomatic:
- lubricating eye drops and tear supplements
- saliva replacement
- regular dental care due to high risk of caries
- pilocarpine may stimulate saliva production
what eye drops can be used
Hypromellose - artificial tears
what can help with the systemic symptoms (and what are they)
arthralgia and fatigue
hydroxychloroquine
when would IS treatment be used
only in context of organ involvement
eg ILD
which antibododies are more commonly found
Ro>La
what cardiovascular risk if there with anti Ro and La antibodies
increased risk of congenital heart block
