Sjogren's Syndrome

Question 1

pathogenesis

Answer 1

autoimmune condition, lymphocytic infiltrates in exocrine organs

Question 2

who gets it?

Answer 2

primary secondary to other AI conditions - RA, SLE

Question 3

how does it present?

Answer 3

dryness of the eyes and mouth - sicca symptoms other symptoms: arthralgia, fatigue, vaginal dryness, parotid gland swelling may occur: peripheral neuropathy and ILD, increased risk of lymphoma

Question 4

how is it diagnosed?

Answer 4

American-European consensus group classification criteria (4 of the following)- ocular symptoms - oral symptoms - ocular signs - oral signs - positive minor salivary gland biopsy findings - positive anti-SSA/anti-SSB (Ro or LA)

Question 5

ocular symptoms

Answer 5

dry eyes for >3 months foreign-body sensation use of tear substitutes >3x daily

Question 6

oral symptoms

Answer 6

dry mouth recurrently swollen salivary glands frequent use of liquids to aid swallowing

Question 7

ocular signs

Answer 7

Schimer test - performed without anaesthesia (<5mm in 5 min)positive vital dye staining results

Question 8

oral signs

Answer 8

abnormal salivary scrintigraphy findings abnormal parotid sialography findings abnormal sailometry findings unstimulated salivary flow <1.5 ml in 25 min

Question 9

what is the management?

Answer 9

Symptomatic
Lubricating eye drops
Saliva replacement products
Pilocarpine can stimulate saliva production

(side effects such as flushing)

Regular dental care - high risk of caries Hydroxychloroquine - arthralgia, fatigue organ involvement (e.g. ILD) -
Other immunosuppression