Sjögren's Syndrome

Question 1

Define Sjögren’s syndrome.

Answer 1

Sjögren’s syndrome is a systemic auto-immune disorder characterised by the presence of dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia) as a consequence of lymphocytic infiltration into the lacrimal and salivary glands.

Question 2

Explain the aetiology/risk factors of Sjögren’s syndrome.

Answer 2

Female
Systemic lupus erythematosus (SLE)
Rheumatoid arthritis
Systemic sclerosis (scleroderma)
HLA class II markers
Age peaks in 20s to 30s and after the menopause

Question 3

Summarise the epidemiology of Sjögren’s syndrome.

Answer 3

Possibly the most common of all systemic auto-immune rheumatic diseases, Sjögren’s syndrome is a systemic auto-immune disorder with a female-to-male ratio of 9:1 and a population prevalence of between 0.5% and 1.56%, depending on the diagnostic criteria used.

Question 4

Recognise the presenting symptoms of Sjögren’s syndrome. Recognise the signs of Sjögren’s syndrome on physical examination.

Answer 4

Fatigue
Dry eyes
Dry mouth
Vasculitis
Dental caries
Increased oral fungal and bacterial infections
Arthralgia
Myalgia

Question 5

Identify appropriate investigations for Sjögren’s syndrome and interpret the results.

Answer 5

Schirmer’s test
Anti-60 kD (SS-A) Ro and anti-La (SS-B)

Question 6

What is Schirmer’s Test?

Answer 6

Quantitatively measures tears. A filter paper is placed in the lower conjunctival sac. The test is positive if less than 5 mm of paper is wetted after 5 minutes.