Sjogren's

Cards (11)

  • Sjögren’s syndrome is an autoimmune condition affecting the exocrine glands, notably the lacrimal and salivary glands,
  • Symptoms:
    • Dry mouth
    • Dry eyes
    • Dry vagina
    • Dry skin
    • Joint pain/stiffness
  • Dry eyes and dry mouth can be called sicca symptoms.
  • Causes of secondary Sjogren's:
    • SLE
    • RA
  • Antibodies associated with Sjögren’s are:
    • Anti-SS-A antibodies (also called anti-Ro)
    • Anti-SS-B antibodies (also called anti-La)
  • Schirmer test:
    • Folded filter paper under the lower eyelid
    • Moisture from the eye will travel by diffusion along the filter paper
    • After 5 minutes <10mm is significant
  • The diagnosis is typically made based on the clinical features and presence of antibodies. Salivary gland biopsy may be used to confirm the diagnosis but is not usually necessary.
  • Treatment options include:
    • Artificial tears (e.g., polyvinyl alcohol eye drops during the day and carbomer gel at night)
    • Artificial saliva
    • Vaginal lubricants
    • Pilocarpine (oral) can be used to stimulate tear and saliva production
    • Hydroxychloroquine may be considered, mainly in patients with associated joint pain
  • Pilocarpine stimulates muscarinic receptors, stimulating the parasympathetic nerves and promoting salivary and lacrimal gland secretion.
  • Complications related to exocrine gland dysfunction include:
    • Eye problems, such as keratoconjunctivitis sicca and corneal ulcers
    • Oral problems, such as dental cavities and candida infections
    • Vaginal problems, such as candida infection and sexual dysfunction
  • Sjögren’s can rarely affect other organs, causing complications such as:
    • Pneumonia
    • Bronchiectasis
    • Non-Hodgkins lymphoma
    • Peripheral neuropathy
    • Vasculitis
    • Renal impairment