This is the appearance of a middle-aged woman with ocular irritation.
a. What does the picture show?
Xerostomia (dry mouth).
b. What is the differential diagnosis?
Pure sicca complex (keratoconjunctiva sicca and dry mouth) which may
occur in post menopausal woman or patients on medication.
This is an autoimmune disorder with cellular infiltration and destruction
of exocrine glands chiefly lacrimal and salivary glands resulting in dry
eyes and mouth.
In primary Sjogren's syndrome, the sicca complex (keratoconjunctiva
and xerostomia) has no systemic association but the blood test is positive
one or more of theses antibodies: anti-Ro or La, ANA (antinuclear antibody)
and rheumatoid body.
In secondary Sjogren's syndrome, the sicca complex is associated with
systemic diseases such as rheumatoid arthritis, systemic lupus erythematosus
c. What systemic signs would you be looking for?
In Sjogren's syndrome there is an increased incidence of autoimmune
disorders and the following signs may be present:
In addition, there may be lymph node enlargement due to the increased incidence
hepatomegaly in association with primary biliary cirrhosis
joints changes in association with rheumatoid arthritis
anaemia in association with pernicious anaemia
Click here for the main page