Sjogren’s syndrome

1. SJOGREN’S SYNDROME

2. Chronic, slowly progressive autoimmune
disease char by lymphocytic infiltrationof
exocrine glands
Char by immunologically mediated
destruction of the exocrine glands –
lacrimal and salivary glands
Mainly affects middle aged woman, may
occur in all ages

3. CLINICAL FEATURES
Keratoconjunctivitis sicca
Xerostomia
Clues:
Difficulty eating buiscuit
Absence of pooling of saliva when
tongue is lifted

4. PE:
Dry, erythematous , sticky oral mucosa
Atrophy of the filiform papillae in the
dorsum of the tongue
Saliva from the major gland is not
expressible or cloudy
Enlargement of parotid or other
salivary glands

5. TYPES
Primary Sjogren’s Syndrome – disease presents
alone
- 0.5 – 1% prevalence
Secondary Sjogren’s Syndrome – inassociation with
another autoimmune disease
- commonly: SLE; RA
- 30% of pts with autoimmune rheumatic disease

6. OTHER CLINICAL FEATURES
Arthritis
Raynaud’s Phenomenon
RenalTubular Defects:
> Diabetes Insipidus
> Renal Tubular Acidosis
Pulmonary Acidosis
Vasculitis
Hodgkin’s B Cell Lymphoma

7. c/o easy fatiguability
Low-grade fever
Myalgias
Arthralgias
Dry cough – attributed to small airway
disease

8. LABS:
Serum Autoantibodies:
ANA (80% of patients)
Anti-rho (60 – 90%)
Rheumatoid Factor
Labial Gland Biopsy: lymphocyte infiltration and
destruction of acinar tissue
SchirmerTest (+): wetting of filter <10mm in 5
minutes

9. DX TEST
Sialometry
Sialography
schintigraphy

11. TREATMENT
Symptomatic:
Artificial tears
Saliva Replacements Solutions
http://crisbertcualteros.page.tl