Sjogrens Syndrome

Question 1

What is Sjogrens Syndrome?

Answer 1

Inflammation + destruction of exocrine glands (usually salivary + lacrimal glands).

Question 2

Describe the aetiology of Sjogrens Syndrome

Answer 2

UNKNOWN
Genetic associations:
HLA-B8
HLA-DR3

Question 3

How do primary and secondary Sjogrens Syndrome differ?

Answer 3

PRIMARY: Idiopathic
SECONDARY: Caused by underlying rheumatologic disease

Question 4

Describe the epidemiology of Sjogrens Syndrome

Answer 4

15-65

F&raquo_space;M

Question 5

List 4 general symptoms of Sjogrens Syndrome

Answer 5

Fatigue
Fever
Weight loss
Depression

Question 6

List 5 sites affected and symptoms experienced due to dryness

Answer 6

Dry eyes (keratoconjunctivitis sicca): gritty + sore
Dry mouth: secondary dysphagia
Dry upper airways: dry cough + recurrent sinusitis
Dry skin or hair
Dry vagina: dyspareunia

Question 7

What symptoms can decreased GI mucus secretion lead to?

Answer 7

Reflux oesophagitis
Gastritis
Constipation

Question 8

List 3 signs of Sjogrens Syndrome

Answer 8

Parotid or salivary gland enlargement
Dry eyes
Dry mouth or tongue

Question 9

Describe blood results in Sjogrens Syndrome

Answer 9

High ESR  
High amylase (if salivary glands involved)

Question 10

What autoantibodies may be seen in Sjogrens Syndrome?

Answer 10

Anti-ENA (Anti-La + Anti-Ro)
Rheumatoid factor
ANA

Question 11

What test for dry eyes may be performed in Sjogrens Syndrome?

Answer 11

Schirmer’s Test
Strip of filter paper placed under eyelid
+ve for Sjogren’s if < 10 mm of strip is wet after 5 mins

Question 12

What stain may be used in suspected Sjogrens Syndrome?

Answer 12

Fluorescein/Rose Bengal Stains

Punctate or filamentary keratitis

Question 13

What other tests may be used in Sjogrens Syndrome?

Answer 13

Reduced parotid salivary flow rate
Reduced uptake or clearance on isotope scan
Biopsy: of salivary or labial glands: focal lymphocytic aggregation