Sjogren's Syndrome

Question 1

What is it?

Primary vs Secondary

Antibodies

Answer 1

This is an autoimmune condition that affects the exocrine glands. It leads to the symptoms of dry mucous membranes, such as dry mouth, dry eyes and dry vagina.

Primary Sjogren’s is where the condition occurs in isolation.

Secondary Sjogren’s is where it occurs related to SLE or rheumatoid arthritis.

It is associated with anti-Ro and anti-La antibodies.

Question 2

Schirmer Test

Answer 2

• inserting a folded piece of filter paper under the lower eyelid with a strip hanging out over the eyelid
• left in for 5 minutes and the distance along the strip hanging out that becomes moist is measured
• tears should travel 15mm in a healthy young adult. A result of less than 10mm is significant.

Question 3

Diagnosis

Answer 3

Antibodies: ANA positive, Anti-Ro, Anti-La

Bloods: hypergammaglobulinaemia, low C4

Schirmer’s test

Question 4

Management

Answer 4

Artificial tears - hypromellose
Artificial saliva
Vaginal lubricants
Hydroxychloroquine is used to halt the progression of the disease.

Question 5

Clinical Features

Answer 5

dry eyes: keratoconjunctivitis sicca
dry mouth
vaginal dryness
arthralgia
Raynaud's
myalgia
sensory polyneuropathy
recurrent episodes of parotitis
renal tubular acidosis (usually subclinical

Question 6

Associated conditions

Answer 6

Pneumonia and bronciectasis
Non-Hodgkins lymphoma
Peripheral neuropathy
Vasculitis
Renal impairment

low-grade marginal-zone B-cell non-Hodgkin mucosa-associated lymphoid tissue (MALT) lymphoma