Sjogren's Syndrome Flashcards
what is sjogrens
systemic multisystem autoimmune disease
what is sicca sjogrens
partial sjogrens (eyes or mouth)
what is primary sjogrens
no connective tissue diseasew
what is secondary sjogrens
connective tissue disease (SLE, rheumatoid arthritis, scleroderma)
what is the aetiology of sjogrens
potential genetic predisposition, low oestrogen risk, dysregulation of inflammatory processes
EBV association
what is the timeline of sjogrens onset
patient has genetic predisposition and then environmental factors occur which triggers the disease
what are the consequences of sjogrens
gradual loss of salivary gland tissue through inflammatory destruction
enlargement of major salivary glands
increased lymphoma risk
oral and ocular effects of loss of moisture
what is the immunopathology of sjogrens
lymphocytic foci (multiple T lymphocytes in the one place)
what is the AECG criteria for sjogrens
4 of:
- dry eyes/mouth
-autoantibody findings
-imaging findings
- radionucleotide assessment
- histopathology
what is the ACR-EULAR criteria for sjogrens
histopathology
autoantibody findings
dry mouth
ultrasound
must have either histology or serology
what is the snowstorm appearance on ultrasounds caused by
holes caused by loss of acini
what are the oral symptoms of sjogrens
daily feeling of dry mouth for >3months
recurrent swelling of salivary glands as an adult
frequently drink liquid to aid swallowing dry foods
what are the ocular symptoms of sjogrens
persistent dry eyes for >3 months
recurrent sensation of sand in eye
tear substitutes used >3 times a day
what do positive autoantibodies mean
they dont cause the disease but are associated with clinical pattern
what autoantibodies are associated with sjogrens
anti-ro and anti-la
what would a positive labial gland biopsy show
collection of >50 lymphocytes around a duct
>1 lymphocytic focus
how do you test for sjogrens
clinical examination
UWS/antii-ro/salivary USS/MRI
labial gland biopsy
how do you manage sjogrens when a patient presents with salivary deficit and dry mouth
major prevention
symptomatic treatment of dryness
salivary stimulants
what do you do if a patient presents early with sjogrens
liaise with rheumatology
consider immune modulating treatment
what are the effects of oral dryness
caries, denture retention, infections, functional issues
