Sjogren's syndrome

Question 1

what is sjogren’s syndrome?

Answer 1

an autoimmune condition that effects the exocrine glands

dry mucous membranes
dry mouth
dry eyes
dry vagina

primary = isolation
secondary= related to SLE / RA

associated with anti-Ro and anti-La antibodies

Question 2

what is schemer test?

Answer 2

insert a folded piece of paper under the lower eyelid with a strip hanging out. leave for five minutes. tears travel 15mm in healthy. <10mm is signfiicant

Question 3

how to manage sjogrens syndrome?

Answer 3

Artificial tears
Artificial saliva
Vaginal lubricants
Hydroxychloroquine is used to halt the progression of the disease.

Question 4

what are the complications of sjogrens syndrome?

Answer 4

Eye infections such as conjunctivitis and corneal ulcers
Oral problems such as dental cavities and candida infections
Vaginal problems such as candidiasis and sexual dysfunction

other organs:

• pneumonia
• bronchiectasis
• non Hogkins
• peripheral neuropathy
• vasculitis
• renal impairment

Question 5

other test for sjogrens

Answer 5

schemer’s test
rose bengal staining (to look for epithelial degeneration)
elevated ESR
pronounced hypergammaglobulinaemia
positive rheumatoid
antinuclear antibodies anti-Ro and anti-La

salivary function
labial gland biopsy
salivary gland scintigraphy

Question 6

management of sjogrens

Answer 6

artificial tears, eye ointment (nocturnal)
tasorrhapy or occlusion of the canliculi to help retain tear film
artificial saliva spray

prompt tx of 2’ infection e.g. conjunctivitis chloramphenicol, oral candidiasis fluconazole

hydroxychloroquine for associated arthritis

corticosteroids