Pathology
- Autoimmune disorder - 90% occur in women, average age 50 years
- Intermittent or constatn swelling of one or all of hte salivary glands
- Diagnosis (at least 2/3)
- Keratoconjunctivitis sicca (dry eyes)
- xerostomia (dry mouth)
- associated connective tissue disorders
- If no associated connective tissue disorders are present, this is known as primary Sjogren's disease
- Pathology:
- lymphocyte-mediated destruction of the exocrine glands secondary to B-cell hyper reactivity and associated loss of suppressor T-cell activity
- x40 increased risk of developing lymphoma, usually B-cell non-Hodgkin's type
- Antibodies: anti-salivary Ab, rheumatoid factor, anti-SSA-Ro and anti-SSB-La
- Investigations
- Schirmer's tests for xerophthalmia (strip of filter paper inserted into each fornix and hyposecretion confirmed by wetting of less than 5mm in 5 minutes - normal is 15 mm)
- Slit-lamp examination of the cornea
- Lip biopsy for histological examination of the minor salivary glands
- Treatment
- Use of artificial tears and saliva
- Systemis steroids
- Careful follow-up due to increased risk of lymphoma