autoimmune disease

1. SJOGREN’S SYNDROME &
SIALOLITHIASIS
BY: M.S.DHANVAANTH HARRAN

2. SJOGREN’S SYNDROME
 It is also called as SICCA SYNDROME
 Lymphoepithelial Sialadenitis ; Autoimmune disorder involving exocrine glands of the body. It is formed
by proliferation of ductus remanants.
 It has characteristics of both types of AI diseases

3. SS
 Onset: middle age
 Long term duration

4. Conti..
 It is of two types: Primary
Secondary
 Primary Sjogren’s syndrome : It is due to involvement of salivary and lacrimal glands.
 It consists of Xerostomia & Xerophthalmia
 It occur on its own and not associated with another illness.

5. Contin..
 DryMouth

6. Conti..
 Xerophthalmia

7. Conti..
 More common in women
 Parotid is commonly involved.
 IT has also been called Mikulicz’s disease or benign lymphoepithelial lesion.

8. Parotid swelling

9. Conti..
 Secondary Sjogren’s syndrome: It develops in persons who has autoimmune disease.
 It has three components:
 Keratoconjunctivitis sicca : involvement of lacrimal glands.It is common in
postmenopausal women.
Xerostomia
Autoimmune connective tissue dis : RA and less commonly SLE.
 Bilateral swelling of saliv glands seen in Scleroderma.

10. KERATOCONJUNCTIVITIS SICCA
 REDDNESS
 DRY EYE

11. Other symptoms

12. Diagnosis
 Blood test and urine test are done to look for presence of antibodies in sjogren’s syndrome
 SCHIRMER’S TEST is done.
 Lip biopsy is done: to detect presence of clusters of inflammatory cells. Here a silver tissue removed from the lip
and examined under microscope.
 SS-A,SS-B antibodies necessary for diag.

13. SCHIRMER’S TEAR TEST

14. Conti..

15. Treatment
 Medication :
 Cyclosporine (restasis), or Xiidra – To decreases eye inflammation.
Cevimeline (evoxac) or Pilocarpine – To increase saliva production. sweating and abd pain occur
sometimes.
 NSAIDs – to treat arthritis.

16. SIALOLITHIASIS
 It is also called SALIVARY CALCULI.
 Calculi form in the ducts of submandibular and parotid glands
 Formed by deposition of calcium phosphates on matrix of mucin or cellular debris

17. Conti..
 Salivary stones are twice as common in males than in female.
 Occur between the age of 30 – 60

18. Pathogenesis

19. Symptoms
 Intermittent Swelling of the glands.
 Pain due to obstruction to outflow of saliva.

20. Other symptoms

21. Diagnosis
 80% stones are radioopaque & can be seen only on x ray.
 Sialography is required for radiolucent stones.
 Ultrasound and contrast sialography are used to reveal the stones.
 SIALOGRAPH is likely to be used.
 NCCT is used for evaluation of sialolithiasis.

22. Treatment
 SIALENDOSCOPY is recently used to treat Sialolithiasis.
 Extracorporeal shockwave lithotripsy: done when stones are not palpable or not visualized.
 NSAIDs are given.

23. Conti..

24. THANK YOU