Sjogren's Syndorme

Question 1

Pathophysiology

Answer 1

Chronic reduction in salivary and lacrimal gland secretions.

Question 2

Associations

Answer 2

1. RA
2. SLE
3. Coeliac
4. Graves

Question 3

Symptoms

Answer 3

Myalgia
Arthralgia
Dry eyes
Fatigue
Raynaud’s
Enlarged Parotids
Dry mouth

Question 4

Investigations

Answer 4

Anti Ro (SLE)
Anti Ds- DNA (SLE)
Rheumatoid Factor (RA)
Salivary gland biopsy (Shows focal lymphocytic infiltration)
Schemer’s test (Tear volume)

Question 5

Treatment

Answer 5

Avoid dry/ smoky/ Dusty environments
Artificial Tears
Artificial Saliva
Emollients/ vaginal lubricants
Rarely immunosuppressants or steroids.

Question 6

Risks

Answer 6

In Anti Ro positive pregnant patients:
1. Foetal heart block
2. Neonatal Lupus
3. Foetal loss

In all patients:
Lifetime B cell lymphoma risk 5-10%