Sjorgen's Syndrome

Question 1

What is Sjogren’s syndrome?

Answer 1

• chronic inflammatory autoimmune disorder
• primary or secondary
• secondary associated with connective tissue disease or RA
• Affects females mainly (9:1)
• Lymphocytic infiltration + fibrosis of exocrine glands, esp lacrimal and salivary glands
• Inc risk of non-hodgkin’s B-cell lymphoma

Question 2

What are clinical features of Sjogren’s?

Answer 2

• Reduced tear production → dry eyes / keratoconjunctivitis sicca
• Reduced saliva production → xerostomia / parotid swelling
• Vaginal dryness / dyspareunia
• Dry cough
• Dysphagia

Question 3

What are investigations for Sjogren’s?

Answer 3

• Schirmer’s test → measures conjunctival dryness
  
  • <5mm in 5 mins is positive
• Rose Bengal staiing may show keratitis (use slit lamp)
• ANA positive in 70%
• Anti-Rho (SSA) in 70%
• Anti-La (SSB) in 30%
• Hypergammaglobulinaemia

Question 4

What is the management of Sjogren’s?

Answer 4

• artifical saliva + tears
• pilocarpine may stimulate saliva production