Sjögren syndrome - Revision history

Kfarzam: /* Differential Diagnosis */

2022-08-17T02:49:05Z

Differential Diagnosis

← Older revision		Revision as of 02:49, 17 August 2022
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	*Sicca complex due to other autoimmune diseases		*Sicca complex due to other autoimmune diseases
	**[[Sarcoidosis]]		**[[Sarcoidosis]]
			**[[IgG4 related disease]]
	**[[Rheumatoid arthritis]]		**[[Rheumatoid arthritis]]
	**[[SLE]]		**[[SLE]]
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	**[[Mumps]]		**[[Mumps]]
	**Seasonal allergies		**Seasonal allergies
	**Cigarette smoke irritation		**Cigarette smoke irritation

	==Evaluation==		==Evaluation==

Elcatracho: /* Clinical Features */

2021-02-10T22:52:10Z

Clinical Features

← Older revision		Revision as of 22:52, 10 February 2021
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	*Gastrointestinal		*Gastrointestinal
	**Primary biliary cirrhosis		**Primary biliary cirrhosis
	**Celiac sprue		**[[Celiac sprue]]


	==Differential Diagnosis==		==Differential Diagnosis==

ClaireLewis at 19:46, 22 August 2019

2019-08-22T19:46:04Z

← Older revision		Revision as of 19:46, 22 August 2019
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	*Respiratory		*Respiratory
	**Pleuritis		**Pleuritis
	**Interstitial lung disease		**[[Interstitial lung disease]]
	**Obstructive lung disease		**Obstructive lung disease
	**[[Pulmonary hypertension]]		**[[Pulmonary hypertension]]
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	*Gastrointestinal		*Gastrointestinal
	**Primary biliary cirrhosis		**Primary biliary cirrhosis
	**~~celiac~~ sprue		**Celiac sprue


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	**Good oral hygiene		**Good oral hygiene
	**Pylocarpine or Cevimeline for severe xerostomia (parasympathetic and muscarinic agonists)		**Pylocarpine or Cevimeline for severe xerostomia (parasympathetic and muscarinic agonists)
	*Hydroxychloroquine for Sjögren's associated arthritis		*[[Hydroxychloroquine]] for Sjögren's associated arthritis
	*[[Prednisone]] or other immunosuppressants (cyclophosphamide or azathioprine for severe systemic symptoms		*[[Prednisone]] or other immunosuppressants ([[cyclophosphamide]] or [[azathioprine]]) for severe systemic symptoms
	*AVOID atropine and decongestants (decrease salivary secretions)		*AVOID [[atropine]] and decongestants (decrease salivary secretions)

	==Disposition==		==Disposition==

Rossdonaldson1: Rossdonaldson1 moved page Sjögren Syndrome to Sjögren syndrome over redirect

2019-04-02T00:53:52Z

Rossdonaldson1 moved page Sjögren Syndrome to Sjögren syndrome over redirect

← Older revision	Revision as of 00:53, 2 April 2019
(No difference)

Taleesha at 21:10, 24 August 2017

2017-08-24T21:10:20Z

← Older revision		Revision as of 21:10, 24 August 2017
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	==Background==		==Background==
	*Systemic autoimmune ~~disease~~		*Systemic autoimmune disorder
			*Lymphocytic infiltration of exocrine glands
	*Can occur in isolation or with other autoimmune diseases (e.g. [[rheumatoid arthritis]], [[SLE]], etc.)		*Can occur in isolation or with other autoimmune diseases (e.g. [[rheumatoid arthritis]], [[SLE]], etc.)
	*Female:male ratio of 9:1		*Female:male ratio of 9:1
			*10-40 fold increased risk of lymphoma in SS patients.

	==Clinical Features==		==Clinical Features==
	*Ocular		*Ocular (xerophthalmia)
	**~~itching~~, burning sensation		**Itching, burning sensation
	**Gritty, foreign body sensation		**Gritty, foreign body sensation
	**[[Dacryoadenitis]]		**[[Dacryoadenitis]]
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	*Respiratory		*Respiratory
	**Pleuritis		**Pleuritis
	**Interstitial lung disease		**Interstitial lung disease
	**Obstructive lung disease		**Obstructive lung disease
	**[[Pulmonary hypertension]]		**[[Pulmonary hypertension]]
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	**[[Cerebral venous thrombosis]]		**[[Cerebral venous thrombosis]]
	**Optic nerve injury		**Optic nerve injury
	*[[Renal tubular acidosis]]		*Renal
			**Interstitial nephritis
			**[[Renal tubular acidosis]]
	**Hyperchloremic [[metabolic acidosis]] with low bicarb and [[hypokalemia]]		**Hyperchloremic [[metabolic acidosis]] with low bicarb and [[hypokalemia]]
	*Chronic interstitial nephritis
	*Cardiac		*Cardiac
	**[[Pericarditis]]		**[[Pericarditis]]
	**[[Arrhythmia]] due to infiltrative disease		**[[Arrhythmia]] due to infiltrative disease
	*Increased risk of [[DVT]]/[[PE]]		*Increased risk of [[DVT]]/[[PE]]
			*Gastrointestinal
			**Primary biliary cirrhosis
			**celiac sprue


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	==Evaluation==		==Evaluation==
			===Emergent===
	*Not generally an ED diagnosis		*Not generally an ED diagnosis
	**Rheumatoid factor is found in 70% of patients
	**May also have anti-SS-A/SS-B antibodies
	*Evaluate for emergent complications		*Evaluate for emergent complications
			*Thorough physical exam to evaluate for purpura (poor prognosis in primary SS)
			===Non-Emergent===
			*Rheumatoid factor is found in 70% of patients
			*Anti-SS-A/Ro, and SS-B/La antibodies are part of diagnostic criteria
			*Elevated ESR
			*Hypergammaglobulinemia


	==Management==		==Management==
	*Manage emergent complications		*Manage emergent complications
	*Topical ocular [[cyclosporine]], artificial tears		*Ocular
	*~~Pylocarpine and cevimeline for severe xerostomia~~		**Topical ocular [[cyclosporine]], preservative-free artificial tears, lubricating ointments
	*Frequent sips of water, chewing gum, or hard candies		*Oral
	*Good oral ~~hygeine~~		**Frequent sips of water, chewing gum, or hard candies
	*[[Prednisone]] or other ~~immunosupressives~~ for severe systemic symptoms		**Good oral hygiene
			**Pylocarpine or Cevimeline for severe xerostomia (parasympathetic and muscarinic agonists)
			*Hydroxychloroquine for Sjögren's associated arthritis
			*[[Prednisone]] or other immunosuppressants (cyclophosphamide or azathioprine for severe systemic symptoms
	*AVOID atropine and decongestants (decrease salivary secretions)		*AVOID atropine and decongestants (decrease salivary secretions)

Mholtz at 08:22, 18 August 2017

2017-08-18T08:22:25Z

← Older revision		Revision as of 08:22, 18 August 2017
Line 69:		Line 69:

	==Disposition==		==Disposition==


	==See Also==		==See Also==
	**[[Sarcoidosis]]		*[[Sarcoidosis]]
	**[[Rheumatoid arthritis]]		*[[Rheumatoid arthritis]]
	**[[SLE]]		*[[SLE]]
	**[[Scleroderma]]		*[[Scleroderma]]

	==External Links==		==External Links==


	==References==		==References==
	<references/>		<references/>

			[[Category:Rheumatology]]

ClaireLewis: Created page with "==Background== Systemic autoimmune disease Can occur in isolation or with other autoimmune diseases (e.g. rheumatoid arthritis, SLE, etc.) *Female:male ratio of 9:1..."

2017-08-17T07:20:35Z

Created page with "==Background== *Systemic autoimmune disease *Can occur in isolation or with other autoimmune diseases (e.g. rheumatoid arthritis, SLE, etc.) *Female:male ratio of 9:1..."

New page

==Background==
*Systemic autoimmune disease
*Can occur in isolation or with other autoimmune diseases (e.g. [[rheumatoid arthritis]], [[SLE]], etc.)
*Female:male ratio of 9:1

==Clinical Features==
*Ocular
**itching, burning sensation
**Gritty, foreign body sensation
**[[Dacryoadenitis]]
**[[Optic neuritis]]
*Parotid enlargement
**Present in 1/3 of patients
**May be chronic or relapsing
**May lead to [[suppurative parotitis]]
*Xerostomia
**Constant thirst
**[[Dental caries]]
*[[Dysphagia]]
*[[Pancreatitis]]
*Respiratory
**Pleuritis
**Interstitial lung disease
**Obstructive lung disease
**[[Pulmonary hypertension]]
**Respiratory arrest due to severe [[hypokalemia]]
*Small-vessel [[vasculitis]]
*Neurologic
**Neuropsychiatric dysfunction
**[[Transverse myelitis]]
**[[Cerebral venous thrombosis]]
**Optic nerve injury
*[[Renal tubular acidosis]]
**Hyperchloremic [[metabolic acidosis]] with low bicarb and [[hypokalemia]]
*Chronic interstitial nephritis
*Cardiac
**[[Pericarditis]]
**[[Arrhythmia]] due to infiltrative disease
*Increased risk of [[DVT]]/[[PE]]

==Differential Diagnosis==
*Sicca complex due to other autoimmune diseases
**[[Sarcoidosis]]
**[[Rheumatoid arthritis]]
**[[SLE]]
**[[Scleroderma]]
*Other causes of dry mouth/dry eyes
**[[Anticholinergic toxicity]]
**[[Radiation exposure]]
**[[Mumps]]
**Seasonal allergies
**Cigarette smoke irritation

==Evaluation==
*Not generally an ED diagnosis
**Rheumatoid factor is found in 70% of patients
**May also have anti-SS-A/SS-B antibodies
*Evaluate for emergent complications

==Management==
*Manage emergent complications
*Topical ocular [[cyclosporine]], artificial tears
*Pylocarpine and cevimeline for severe xerostomia
*Frequent sips of water, chewing gum, or hard candies
*Good oral hygeine
*[[Prednisone]] or other immunosupressives for severe systemic symptoms
*AVOID atropine and decongestants (decrease salivary secretions)

==Disposition==

==See Also==
**[[Sarcoidosis]]
**[[Rheumatoid arthritis]]
**[[SLE]]
**[[Scleroderma]]

==External Links==

==References==
<references/>