Sjogren's Syndrome

Question 1

Define “focal lymptocytic sialadenitis”

Answer 1

Foci of lymphocytes around perivascular/periglandular spaces. May form germinal centers.

Question 2

Which virus may precipitate onset of Sjogren’s Syndrome?

Answer 2

EBV. EBNA-1 may mimic certain Ag pattern found in SSA/Ro.

Question 3

Define SSA/Ro and SSA/La

Answer 3

Ribonucleoprotein complex that helps degrade misformed RNA.

Question 4

Pathogenesis of Sjogren’s Syndrome

Answer 4

Proposed mechanism: impair phagocytosis of apoptotic cells leads to decreased self-tolerance due to presentation of self-Ag (SSA/Ro). Subsequent involvement in SSA/La is possible when bound Ags are picked up together.

Question 5

Autoantibodies directed towards muscarinic receptor 3 (MR3)

Answer 5

Blocks endothelial cell signal necessary for production and release of H2O and Cl-

Question 6

Lissamine Green

Answer 6

Dye that binds that ocular epithelial cells that are unprotected by mucin => xerostomia. Divitalized tissue (filaments) may be seen.

Question 7

Fluoroscein dye

Answer 7

Used to measure quality of tear film based on time for evenly dispersed dye to “break up”

Question 8

SjS associated extra-glandular diseases

Answer 8

1. Non-Hodgkin’s Lymphoma (marginal zone B-cell lymphoma and MALT)