Sjogren's Syndrome

Question 1

What is Sjogren’s syndrome ?

Answer 1

• This is an autoimmune condition that affects the exocrine glands leading to dry mucosal surfaces.
• Can be primary or secondary to RA/ other connective tissue disorders (usually 10 years after initial onset)
• More common in women (9:1 ratio).
• Increased risk of lymphoid malignancy (40-60 fold).

Question 2

features of Sjogren’s ?

Answer 2

1) Dry eyes
2) Dry mouth
3) Vaginal dryness
4) Arthralgia
5) Raynaud’s
6) Myalgia
7) Sensory polyneuropathy
8) Recurrent episodes parotitis
9) Renal tubular acidosis

Question 3

investigations for sjogren’s ?

Answer 3

1) RF
2) ANA
3) Anti-Ro
4) Anti-La
5) Schirmer’s test – measure tear formation
6) Histology – focal lymphocytic infiltration
7) May also find: hypergammaglobulinemia, low C4

Question 4

how is schirmer’s test carried out?

Answer 4

1) Insert a folded piece of filter paper under lower eyelid with strip hanging out over eyelid.
2) Leave for 5 minutes
3) Measure distance that tear has travelled, should be around 15mm in healthy young adult.
4) <10mm is significant

Question 5

how is sjogren’s managed?

Answer 5

1) Artificial tears
2) Artificial saliva
3) Vaginal lubricant
4) HCQ to stop progression of disease

Question 6

complications of dry mucosal surfaces in sjogren’s?

Answer 6

Complications

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

Question 7

sjogren’s associated complications?

Answer 7

Sjogren’s can lead to complications such as:

1) Pneumonia
2) Bronchiectasis
3) Non-Hodgkin’s lymphoma
4) Peripheral neuropathy
5) Vasculitis
6) Renal impairment