Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- fatigue
- dry eyes
- dry mouth
Otros factores de diagnóstico
- vasculitis
- dental caries
- increased oral fungal and bacterial infections
- musculoskeletal pain
- thyroid disease
- urogenital disease
- pulmonary disease
- gastrointestinal disease
- peripheral neuropathy
- corneal ulceration
- no saliva pool
- enlarged salivary glands
- facial pain
- burning mouth syndrome
Factores de riesgo
- female
- systemic lupus erythematosus (SLE)
- rheumatoid arthritis
- systemic sclerosis (scleroderma)
- HLA class II markers
- age 40 to 70
- genetic inheritance
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- Schirmer test
- anti-60 kD (SS-A) Ro and anti-La (SS-B)
Pruebas diagnósticas que deben considerarse
- 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
Pruebas emergentes
- MRI salivary glands
- ultrasound salivary glands
Algoritmo de tratamiento
dry eyes
dry mouth
with fatigue
with musculoskeletal manifestations
with vasculitis
with renal tubular acidosis
with neuropathy
Colaboradores
Autores
Biji T. Kurien, PhD
Staff Scientist
Arthritis and Clinical Immunology Research Program
Oklahoma Medical Research Foundation
Research Associate
Department of Veterans Affairs
Oklahoma City
OK
Divulgaciones
BTK is an author of several articles cited in this topic.
R. Hal Scofield, MD
Professor
Section of Endocrinology and Diabetes
Department of Medicine
University of Oklahoma Health Sciences Center
Member
Arthritis and Clinical Immunology Research Program
Oklahoma Medical Research Foundation
Associate Chief of Staff for Research and Staff Physician
Department of Veterans Affairs Medical Center
Oklahoma City
OK
Divulgaciones
RHS has received compensation from Jessen Pharmaceuticals as a member of a clinical trial advisory board, and honorarium from Merck and Company for consultation on an investigational agent for Sjogren’s syndrome. RHS is the principal investigator for grants from the US National Institute of Health and the US Department of Veteran Affairs for institutions studying Sjorgren’s syndrome. RHS is an author of several articles cited in this topic.
Revisores
Nora Sandorfi, MD
Associate Professor of Medicine
University of Pennsylvania
Philadelphia
PA
Declarações
NS declares she has no competing interests.
Créditos aos pareceristas
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Declarações
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Referências
Principais artigos
Foulks GN, Forstot SL, Donshik PC, et al. The Sjogren's Syndrome Foundation clinical practice guidelines. Ocular management in Sjogren's patients. 2015 [internet publication].Texto completo
Vivino FB, Zero D, Brennan M, et al. Sjogren's Syndrome Foundation's clinical practice guidelines. Oral management: caries prevention in Sjogren's patients. 2015 [internet publication].Texto completo
Carsons SE, Vivino FB, Parke A, et al. Treatment guidelines for rheumatologic manifestations of Sjögren's syndrome: use of biologic agents, management of fatigue, and inflammatory musculoskeletal pain. Arthritis Care Res (Hoboken). 2017 Apr;69(4):517-27.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Systemic lupus erythematosus (SLE)
- Rheumatoid arthritis
- Hepatitis C
Mais Diagnósticos diferenciaisDiretrizes
- 2023 American College of Rheumatology (ACR) guideline for the treatment of interstitial lung disease in people with systemic autoimmune rheumatic disease
- 2022 American College of Rheumatology guideline for vaccinations in patients with rheumatic and musculoskeletal disease
Mais Diretrizes
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