Last reviewed: November 2017
Last updated: October  2017

Summary

Definition

History and exam

Key diagnostic factors

  • fatigue
  • dry eyes
  • dry mouth

Other diagnostic factors

  • vasculitis
  • dental caries
  • increased oral fungal and bacterial infections
  • arthralgia
  • myalgia
  • arthritis
  • kidney disease
  • peripheral neuropathy
  • corneal ulceration
  • no saliva pool
  • enlarged salivary glands
  • facial pain
  • burning mouth syndrome
  • hx of venous thromboembolism

Risk factors

  • female
  • systemic lupus erythematosus (SLE)
  • rheumatoid arthritis
  • systemic sclerosis (scleroderma)
  • HLA class II markers
  • genetic inheritance
  • age peaks in 20s to 30s and after menopause

Diagnostic investigations

1st investigations to order

  • Schirmer test
  • anti-60 kD (SS-A) Ro and anti-La (SS-B)
Full details

Investigations to consider

  • sialometry
  • minor salivary gland biopsy
  • lissamine green test
  • fluorescein corneal staining test
  • parotid sialography
  • salivary gland technetium-99m pertechnetate scintigraphy
  • skin biopsy
  • angiography
  • urinalysis
  • serum electrolytes
Full details

Emerging tests

  • MRI salivary glands
  • ultrasound salivary glands
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Associate Professor of Research

Section of Endocrinology and Diabetes

Department of Medicine

University of Oklahoma Health Sciences Center

Affiliate

Arthritis and Clinical Immunology Research Program

Oklahoma Medical Research Foundation

Oklahoma City

OK

Disclosures

BTK declares that he has no competing interests.

Professor and Director of Fellowship Program

Section of Endocrinology and Diabetes

Department of Medicine

University of Oklahoma Health Sciences Center

Member of Arthritis and Clinical Immunology Research Program

Oklahoma Medical Research Foundation

Oklahoma City

OK

Disclosures

RHS has been a paid consultant for UCB in regards to Sjogren's and he has received honorarium for speaking on Sjogren's at Lily. Both instances included travel expenses.

Peer reviewers VIEW ALL

Head of Unit

Queen Elizabeth Hospital

Woodville South

South Australia

Australia

Disclosures

MR declares that she has no competing interests.

Associate Professor of Medicine

Johns Hopkins University

Baltimore

MD

Disclosures

AB declares that he has no competing interests.

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