Sjogren's syndrome

Question 1

What is Sjogren’s?

Answer 1

Autoimmune condition affecting the exocrine glands, leading to symptoms of dry mucous membranes

Question 2

Two types of Sjogren’s?

Answer 2

Primary - disease occurs in isolation

Secondary - to SLE or RA

Question 3

Presentation of Sjogren’s?

Answer 3

Dry mouth
Dry eyes
Dry vagina

Question 4

Investigations in suspected Sjogren’s

Answer 4

Rheumatology screen:

• RF
• ANA
• CRP. ESR
• Plus FBC, U&Es, LFTs
• Autoantibody screen - anti-Ro and anti-La are associated with Sjogren’s

Schirmer test:

• Filter paper under the lower eyelid
• Distance that becomes moist is measured
• <10mm is low (>15 normally)

Question 5

Management of Sjogren’s

Answer 5

Artificial saliva and tears

Treat underlying RA, SLE if it is secondary to that

Hydroxychloroquine is used to halt the progression of the disease.

Question 6

Complications of Sjogren’s

Answer 6

Eye infections e.g. conjunctivitis, corneal ulcers

Mouth - dental cavities, oral candidiasis

Vaginal - candidiasis and sexual dysfunction

Increased risk of Non-Hodgkin’s lymphoma

Vasculitis

Renal impairment

Pneumonia and bronchiectasis