Sjogren's Syndrome

Question 1

define Sjogren’s

Answer 1

a chronic systemic autoimmune disease characterised by dry mouth and eyes
association with inflammation of the exocrine glands and other bodily tissues
may be primary or secondary to another condition

Question 2

more common in males or females?

Answer 2

females (9:1)

Question 3

diagnosis based on:

Answer 3

typical clinical symptoms:
- dry eyes
- hyperglobulinaemia
- poor salivary flow
- parotid enlargement
- antibody presence
- salivary gland biopsy

Question 4

schirmer’s test

Answer 4

testing for presence of dry eyes
placing filter paper inside the lower lid of the eye (gross)
paper is removed and then tested for moisture content

Question 5

ocular staining

Answer 5

testing for presence of dry eyes
application of stains in the form of eye drops
to ascertain the presence of reduced tear volume through detection of damagedd epithelial cells
the white of the eye normally should not take up stain

Question 6

pathophysiology of sjogrens

Answer 6

dysregulation of epithelial cells
causes activation of APC dendritic cells and lymphocytes
T cells interact with epithelial cells and produce pro inflammatory cytokines
ongoing glandular inflammation and damage

Question 7

sjogrens is associated with which antibodies

Answer 7

Ro (SSA) and La (SSB)
rheumatoid factors

Question 8

clinical features of sjogrens

Answer 8

vaginal dryness
chronic bronchitis
poor dental hygiene
glandular and parotid swelling
insidious onset
faatigue
raynaauds
autonomic dysfunction
involvement of kidneys, blood vessels, lungs, liver, pancreas

Question 9

Sjogrens has clinical features that are similar to

Answer 9

SLE (lupus)

Question 10

how to differentiate sjogrens from SLE

Answer 10

• Ro and La antibodies are not SLE diagnostic criteria
• lupus is not associated with lymphoma
• sjogrens not associated with photophobia
• sjogrens is primarily an exocrine gland disorder

Question 11

mainstay of treatment

Answer 11

symptomatic/supportive
manage organ involvement
if secondary treat underlying condition

Question 12

symptomatic treatment for dry eyes

Answer 12

cyclosporine eye drops
oral pilocarpine
ophthalmology care

Question 13

symptomatic treatment of dry mouth

Answer 13

chewing gum
dental care, cleaning, fluoride

Question 14

complications of sjogrens

Answer 14

increased risk of neonatal lupus in women with Sjogrens
Ro antibody is associated with foetal heart block, pregnant women require monitoring of the foetus
lymphoid malignancy occurs in 5% - screen for lymphoma, more common in severe cases

Question 15

presence of Ro and La are associated with

Answer 15

more severe disease

Question 16

prognosis of sjogrens

Answer 16

may progress, could plateau, or could regress.
whatever the fuck it wants to do really.