Sjogren's Syndrome

Question 1

What is Sjogren’s syndrome?

Answer 1

An autoimmune disease where there is destruction of the exocrine glands of the body- most commonly affects the salivary glands and lacrimal glands

Question 2

What are some of the presenting features of Sjogren’s syndrome?

Answer 2

Dry mouth (xerostomia)- cracks, dissures and decreased taste
Parotid enlargement

Dry eyes
Red eyes
Gritty sensation in eyes
Itchy eyes
Blurred vision
Keratoconjunctivitis 

Vaginal dryness
Nasal bleeding
Arthralgia

Question 3

Who is commonly affected by Sjogren’s syndrome?

Answer 3

Most often affects women aged 40 to 50 years

Question 4

What are patients with sjogren’s syndrome more at risk of?

Answer 4

Lymphoid malignancy- 40-60x greater risk

Question 5

What immunology tests would you request if suspecting Sjogren’s?

Answer 5

ANA
Anti- Ro (positive in 70%)
Anti-La (positive in 30%)
Rheumatoid factors (positive in almost 100%)

Question 6

What investigations would you do if suspecting Sjogren’s syndrome?

Answer 6

Immunology- RF, ANA, Anti-Ro, Anti-La

Schirmer’s Test- Filter paper in the eye- less than 5 cm in 5 min = +ve result

Biopsy- typically of the lip, shows inflammation and fibrotic change

Question 7

What is the management for Sjogren’s syndrome?

Answer 7

Artificial tears
Artificial saliva
Stay hydrated
Pilocarpine can increase secretions

NSAIDs and hydroxyquinoline for arthralgia

If severe- steroids, immunosuppression

Question 8

Where is a biopsy taken from when investigating for Sjogren’s syndrome?

Answer 8

A biopsy is often taken from the lips