Sjogren's syndrome is an autoimmune disease characterized by lymphocytic infiltration and destruction of the exocrine glands, mainly the lacrimal and salivary glands, causing symptoms of dry eyes and dry mouth. It most commonly affects middle-aged women and clinical features include keratoconjunctivitis sicca, xerostomia, and a dry, sticky oral mucosa. Sjogren's syndrome can occur alone as primary Sjogren's or associated with other autoimmune diseases like SLE or RA, known as secondary Sjogren's. Diagnosis involves blood tests for autoantibodies, biopsy of the labial salivary gland, and tests of tear and saliva production

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
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