Sjogrens Syndrome

Question 1

Define Sjogrens

Answer 1

Autoimmune disease affecting salivary glands/lacrimal

Question 2

What other conditions can Sjogrens be linked to?

Answer 2

• Lupus
• RA
• Scleroderma

Question 3

Causes of Sjogrens

Answer 3

Genetics
Infections
Diet
Toxic chemicals

Question 4

Consequences of Sjogrens (4)

Answer 4

Oral dryness
- Caries risk
- Denture retention
- Oral infection
- Functional issues - speech/swallow

Enlargement of major salivary glands (late finding)

Increased risk of lymphoma (5% anywhere/salivary gland)

Question 5

How does sjogrens reduce production of saliva? (3)

Answer 5

• Autoimmune process mediated by T lymphocytes
• Destroys acinar tissue within the salivary glands
• Reduces ability to produce saliva

Question 6

Histopathological feature of Sjogrens

Answer 6

Lymphocytic foci (>50)

Question 7

Classification system for Sjogrens

Answer 7

AECG

Question 8

Auto-antibody findings for Sjogrens

Answer 8

Anti Ro
Anti La

Question 9

Diagnostic tests for Sjogrens

Answer 9

Labial gland biopsy
Autoantibody - AntiRo/La
Dry eyes/mouth
Ultrasound

Question 10

Ultrasound appearance of Sjogrens

Answer 10

Snowstorm appearance
Loss of acini (causes holes to appear within gland)
Leopard spot appearance

Question 11

Sjogrens Syndrome AECG eye signs

Answer 11

Schirmer test
<5mm wetting in 5 mins

Fluorescein tear assessment

Question 12

Sjogrens Syndrome AECG oral signs

Answer 12

Abnormal unstimulated salivary flow
<1.5ml in 15 mins

Question 13

If Sjogrens diagnosed what test do we want

Answer 13

Baseline MRI

Question 14

Management of Sjogrens Syndrome

Answer 14

OH - diet High F paste
Dry mouth - Orthana spray, sugar free gum

Question 15

Why is sjogrens hard to spot early on

Answer 15

Dry mouth only once gland destruction

Lisa with Rheumatologist - multi system disease
Consider immune modulating hydroxychloroquine