Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- fadiga
- olhos secos
- xerostomia
Outros fatores diagnósticos
- vasculite
- cárie dental
- presença de fatores de risco
- maior número de infecções orais bacterianas e fúngicas
- dor musculoesquelética
- doença tireoidiana
- doença urogenital
- doença pulmonar
- doença gastrointestinal
- neuropatia periférica
- ulceração corneana
- ausência de acúmulo de saliva
- glândulas salivares aumentadas
- dor facial
- síndrome da boca ardente
Fatores de risco
- mulheres
- lúpus eritematoso sistêmico (LES)
- artrite reumatoide
- esclerose sistêmica (esclerodermia)
- marcadores de antígeno leucocitário humano (HLA) de classe II
- idade de 40 a 70
- herança genética
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- teste de Schirmer
- anti-Ro 60 kD (SS-A) e anti-La (SS-B)
Investigações a serem consideradas
- sialometria
- biópsia das glândulas salivares menores
- teste de verde de lissamina
- teste de coloração da córnea com fluoresceína
- sialografia da parótida
- cintilografia com pertecnetato de tecnécio-99m das glândulas salivares
- biópsia de pele
- angiografia
- urinálise
- eletrólitos séricos
Novos exames
- ressonância nuclear magnética (RNM) das glândulas salivares
- ultrassonografia das glândulas salivares
Algoritmo de tratamento
olhos secos
xerostomia
com fadiga
com manifestações musculoesqueléticas
com vasculite
com acidose tubular renal
com neuropatia
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
Disclosures
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
Disclosures
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 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 syndrome. RHS is an author of several articles cited in this topic.
Peer reviewers
Nora Sandorfi, MD
Associate Professor of Medicine
University of Pennsylvania
Philadelphia
PA
Disclosures
NS declares she has no competing interests.
References
Key articles
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].Full text
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].Full text
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.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Lúpus eritematoso sistêmico (LES)
- Artrite reumatoide
- Hepatite C
More DifferentialsGuidelines
- 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
More Guidelines
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