Rheumatology: Sjogren's

Question 1

What is Sjogren’s syndrome?

Answer 1

Chronic autoimmune inflammatory disorder

Characterized by diminished lacrimal and salivary gland secretion

• Primary form = not associated with other diseases
• Secondary form = associated with another underlying rheumatic disease

Question 2

What are the signs and symptoms of Sjogren’s?

Answer 2

Mnemonic – MADFRED

• Myalgia
• Arthralgia
• Dry Mouth (xerostomia)
• Fatigue
• Raynaud’s phenomenon
• Enlarged parotids
• Dry eyes (xerophthalmia)

Question 3

How should Sjogren’s be investigated?

Answer 3

Anti Ro and Anti La Antibodies – 90% of patients

RF + anti ds-DNA antibodies may be seen

Schirmer’s test- measures tear volume

Salivary gland biopsy may be needed

Question 4

Outline the management of Sjogren’s

Answer 4

Essentially symptomatic

Avoid dry or smoky atmospheres

Dry eyes - artificial tears

Dry mouth -artificial saliva, sugar free gum/pastilles

Skin emollients, vaginal lubricants

Immunosuppressants/steroids rarely needed