Sjogrens Syndrome Flashcards
Define Sjogrens
Autoimmune disease affecting salivary glands/lacrimal
What other conditions can Sjogrens be linked to?
- Lupus
- RA
- Scleroderma
Causes of Sjogrens
Genetics
Infections
Diet
Toxic chemicals
Consequences of Sjogrens (4)
Oral dryness
- Caries risk
- Denture retention
- Oral infection
- Functional issues - speech/swallow
Enlargement of major salivary glands (late finding)
Increased risk of lymphoma (5% anywhere/salivary gland)
How does sjogrens reduce production of saliva? (3)
- Autoimmune process mediated by T lymphocytes
- Destroys acinar tissue within the salivary glands
- Reduces ability to produce saliva
Histopathological feature of Sjogrens
Lymphocytic foci (>50)
Classification system for Sjogrens
AECG
Auto-antibody findings for Sjogrens
Anti Ro
Anti La
Diagnostic tests for Sjogrens
Labial gland biopsy
Autoantibody - AntiRo/La
Dry eyes/mouth
Ultrasound
Ultrasound appearance of Sjogrens
Snowstorm appearance
Loss of acini (causes holes to appear within gland)
Leopard spot appearance
Sjogrens Syndrome AECG eye signs
Schirmer test
<5mm wetting in 5 mins
Fluorescein tear assessment
Sjogrens Syndrome AECG oral signs
Abnormal unstimulated salivary flow
<1.5ml in 15 mins
If Sjogrens diagnosed what test do we want
Baseline MRI
Management of Sjogrens Syndrome
OH - diet High F paste
Dry mouth - Orthana spray, sugar free gum
Why is sjogrens hard to spot early on
Dry mouth only once gland destruction
Lisa with Rheumatologist - multi system disease
Consider immune modulating hydroxychloroquine
