Sjogrens Syndrome

Question 1

What is it?

Answer 1

Autoimmune condition that causes chronic inflammation of exocrine glands

Can be primary or secondary

Question 2

What is primary and secondary SS?

Answer 2

Primary- dry eyes in absence of autoimmune disease

Secondary- sicca symptoms (dry eyes and mouth) in presence of autoimmune disease e.g. RA, SLE

Question 3

What are the symptoms?

Answer 3

Dry eyes
Dry mouth
Salivary and parotid gland enlargement
Vaginal dryness
Systemic symptoms
-arthralgia 
-raynauds
-oesophageal motility problems

Question 4

What investigations are needed?

Answer 4

Schirmer test

• fold filter paper under lower eyelid with strip hanging over the edge
• leave on for 5 mins and measure the amount of strip that is moist
• Normal = 15mm
• Abnormal <10mm

Bloods

• RF=raised
• ANA=raised in 70%
• Anti-ro +ve in 70%
• Anti-La +ve in 70%

Question 5

What is the management?

Answer 5

Artificial tears
Artificial saliva
Vaginal lubricants
Hydroxychloroquine to stop progression

Good prognosis

Question 6

What are complications?

Answer 6

Eye infections- conjunctivitis and corneal ulcers

Oral problems e.g. dental cavities and candida

Vaginal problems e.g. sexual dysfunction and candidiasis

Rarely can cause non-hodgkins lymphoma