Sjogren's Syndrome
· Assosiation of dryness of the mouth of dryness of the eyes(+rheumatoid arthritis)
Primary Sjogrens syndrome(Sicca syndrome)
· Dry mouth+Dry eyes , not associated with any connective tissue disease
Secondary Sjogrens syndrome
· Dry mouth+Dry eyes , associated with rheumatoid arthritis or other connective tissue disease
Oral effects of sjogrens syndrome
· Discomfort
· Difficulties with eating and swallowing
· Disturbed taste sensation
· Disturbed quality of speech
· Predisposition to infection
Clinical features
· In established cases oral mucosa often dry,red,shiny,parchment like
· Tongue-typically red,atrophic papillae,dorsum of the tongue become lobulated coblestone appearance
· Candidal infections are common
· Later generalized erythema of the mucosa occur
· Infective suppurative parotitis may occur
Occular effects of sjogrens syndrome
· Failure of tear secretion
· Failure of clearance of foreign particles from the cornea and conjunctiva(keratoconjinctivitis sicca)
· Griity sensation of the eyes and inflammation
· Risk of impairment or loss of sight
Aetiology & Pathology
· Autoimmune disease
· The disease is systemic and affects all exocrine glands including those of the skin,vagina,lung and pancreas.
· Lymphocytes(CD4) infiltrate the glands and cluster around duct replacing acinar cells
· Progressive destruction of secretory acini
· Proliferation of some duct tissues as epimyoepithelial islands(myoepithelial syeloadenitis)
· Finally destruction of acini and replacement of the whole gland by dense lymphocytic infiltrate
· Auto antibodies-Salivary duct antibodies,Rheumatoid factor,SS-A,SS-B,Rheumatoid arthritis precipitin
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