Sjogren's syndrome Flashcards
Define Sjogren’s syndrome
Characterised by inflammation & destruction of exocrine glands (usually salivary & lacrimal glands)
Aetiology of Sjogren’s syndrome
UNKNOWN
Genetic associations of Sjogren’s syndrome
2
HLA-B8
HLA-DR3
Associated autoimmune disease to Sjogren’s syndrome
5
Rheumatoid arthritis Scleroderma SLE Polymyositis Organ specific autoimmune disease (e.g. PBC, autoimmune hepatitis, myasthenia gravis)
Presenting symptoms of Sjogren’s syndrome
10
Fatigue
Fever
Weight loss
Depression
Dry eyes (keratoconjunctivitis sicca) - gritty & sore
Dry mouth - leads to secondary dysphagia
Dry upper airways - leads to dry cough & recurrent sinusitis
Dry skin or hair
Dry vagina - may cause dyspareunia
Reduced GI mucus secretions leads to reflux oesophagitis, gastritis & constipation
Signs of Sjogren’s syndrome on physical examination
4
Parotid or salivary gland enlargement
Dry eyes
Dry mouth or tongue
Signs of associated conditions
Investigations for Sjogren’s syndrome
6 types
Bloods Autoantibodies Schirmer's test Fluorescein/rose bengal stains Other investigations Biopsy
Investigations for Sjogren’s syndrome - bloods
2
High ESR High amylase (if salivary glands involved)
Investigations for Sjogren’s syndrome - autoantibodies
3
Rheumatoid factor
ANA
Anti-ENA (extractable nuclear antigens)
Investigations for Sjogren’s syndrome - schirmer’s test
2
Strip of filter paper placed under eyelid
Positive for Sjogren’s syndrome if < 10mm of strip is wet after 5 mins
Investigations for Sjogren’s syndrome - fluorescein/rose bengal stains
May show punctate or filamentary keratitis
Investigations for Sjogren’s syndrome - other
2
Reduced parotid salivary flow rate
Reduced uptake or clearance on isotope scan
Investigations for Sjogren’s syndrome - biopsy
Of salivary or labial glands
