Jumat, 24 Desember 2010

Sjogren's syndrome

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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