Sjӧgren’s Syndrome Flashcards
What is Sjӧgren’s Syndrome?
Autoimmune disorder affecting exocrine glands
What are the 2 types of Sjӧg
Primary
Secondary
What is associated with secondary Sjӧgren’s Syndrome?
Other autoimmune connective tissue diseases
- SLE
- RA
- Scleroderma
What is Sicca Syndrome?
Dryness of the exocrine glands
What are the other causes of Sicca Syndrome?
Aging DM Hep C AIDS Parkinson’s Dz Head and neck radiation Sarcoidosis Medications
What medications are involved in Sicca Syndrome?
Antidepressants Antihistamines Antipsychotics Incontinence medications Isotretinoin Diuretics
Can Sicca Syndrome be independent of Sjӧgren’s Syndrome?
YES
What is associated with Sjӧgren’s Syndrome?
Genetics
Viruses
- Epstein-Barr virus
- Retroviruses
- Coxsackieviruses
- CMV
- Hep C
What the eye manifestations of Sjӧgren’s Syndrome?
Xerophthalmia Keratoconjunctivitis sicca Corneal ulcers and scarring Bacterial keratitis Eyelid infections
What is keratoconjunctivitis sicca?
Damage to corneal and conjunctival epithelia Foreign-body senstation Grittiness Irritation Photosensitivity
What is xerostomia?
Difficulty swallowing Dental caries/infections - Fungal infections- candidiasis Pain with eating salty/spicy foods Difficulty talking Parotid gland enlargement
What are the constitutional symptoms?
- Fatigue
- Low-grade fever
What are the sin and vascular symptoms?
- Xerosis
- Vasculitis
- Raynaud’s phenomenon
- Photosensitivity
What are the pulmonary symptoms?
- Chronic bronchitis
- Bronchiectasis
- COPD
What are the MSK symptoms?
- Polyarthritis
- Polymyositis
What are the renal symptoms?
- Tubular interstitial nephritis
- Glomerulonephritis
What are the neurology signs?
- Peripheral neuropathy
What are the neoplasia signs?
- Lymphadenopathy
- Lymphoma
What is the workup for Sjӧgren’s Syndrome?
Ocular and oral exams
- Schirmer test
Labs CBC w/diff RA ANA - Anti-SS-A (Ro) or anti-SS-B (La)- 40% of pts
Salivary gland biopsy
What is the DDX of Sjӧgren’s Syndrome?
Medication related dryness Age-related exocrine gland dysfunction Mouth breathing HIV Hep C DM
What is I diagnosis criteria of Sjӧgren’s Syndrome?
I. Ocular symptoms
- Dry eyes > 3 mon
- foreign-body sensation
- use of tear substitute > 3 x a day
What is the NON-Medication treatment for Sjӧgren’s Syndrome?
Fluid replacement
Humidifiers
Proper oral hygiene
Annual eye and dental exams
What is the Medication treatment for Sjӧgren’s Syndrome?
Artificial tears Pilocarpine/Cevimeline - Dry mouth Hydroxychloroquine - Arthralgias and cutaneous manifestations
What is the patho of Sjӧgren’s Syndrome?
- Lymphocytic and plasma cell infiltration
- Glands that secrete moisture
- Salivary and lacrimal glands
What is II diagnosis criteria of Sjӧgren’s Syndrome?
II. Oral symptoms
- Dry mouth > 3 mons
- recurrent swollen salivary glands
- use of liquids to aid swallowing
What is III diagnosis criteria of Sjӧgren’s Syndrome?
III. Ocular signs
- Positive test- Schirmer or Rose Bengal score
What is IV diagnosis criteria of Sjӧgren’s Syndrome?
IV. Salivary gland involvement
- Abnormal salivary scintigraphy
- parotid sialography
- abnormal salivary flow
What is V diagnosis criteria of Sjӧgren’s Syndrome?
V. Positive minor salivary gland biopsy findings
What is VI diagnosis criteria of Sjӧgren’s Syndrome?
VI. Positive anti-SSA or anti-SSB antibody results
