Sjögren's Syndrome

Question 1

what is sjögren’s syndrome?

Answer 1

an autoimmune disorder, which is characterised by the reduced function of the lacrimal and salivary glands

Question 2

what are the symptoms of sjögren’s syndrome?

Answer 2

• keratoconjunctivitis sicca (e.g. irritation of the eye, blurred vision, itching, photophobia, ulceration of the cornea, reduced production of tears)
• xerostomia (e.g. dryness of the mouth, difficulty speaking or eating, alteration of taste, absence of sublingual pooling of saliva)
• enlargement of the salivary glands

Question 3

what are the investigations for sjögren’s syndrome?

Answer 3

• schirmer’s test
• sialometry
• urinalysis
• FBC
• ESR
• CRP
• U&Es
• LFTs
• autoantibody (e.g. ANA, anti-Ro, anti-La, anti-CCP, ant-dsDNA, RF)
• biopsy (e.g. salivary glands)

Question 4

what is the management of sjögren’s syndrome?

Answer 4

• eyedrops
• topical NSAIDs or corticosteroids
• topical cyclosporin
• artificial saliva
• pilocarpine
• ? corticosteroids (e.g. methylprednisolone)
• ? immunosuppressant (e.g. leflunomide, methotrexate, azathioprine)
• ? biologic (e.g. rituximab)

Question 5

what are the long-term complications of sjögren’s syndrome?

Answer 5

• NHL
• ulceration of the cornea
• ulceration of the mouth
• oral candidiasis
• dental caries
• vasculitis
• peripheral neuropathy
• ILD
• perimycocarditis