Sjogren syndrome

Sjogren syndrome

Q. 1

Biopsy of the parotid gland in a patient with Sjogren’s syndrome shows –

 A

Neutrophils

 B

Lymphocytes

 C

Eosinophi Is

 D

Basophils

Q. 1

Biopsy of the parotid gland in a patient with Sjogren’s syndrome shows –

 A

Neutrophils

 B

Lymphocytes

 C

Eosinophi Is

 D

Basophils

Ans. B

Explanation:

Ans. is ‘b’ i.e., Lymphocytes

o The earliest histological finding in both the major and minor salivary glands is periductal and perivascular lymphocytic infilteration which eventually becomes extensive


Q. 2

Sjogren’s syndrome refers to disease of ‑

 A

Parotid glands

 B

Thyroid disease

 C

Parathyroid glands

 D

Multiple endocrine neoplasia

Q. 2

Sjogren’s syndrome refers to disease of ‑

 A

Parotid glands

 B

Thyroid disease

 C

Parathyroid glands

 D

Multiple endocrine neoplasia

Ans. A

Explanation:

Ans. is ‘a’ i.e., Parotid glands 


Q. 3

All of the following are true about Primary Sjogren’s syndrome, except:

 A

May be seen in children

 B

Sensation of sand or gravel in eyes

 C

Associated with rheumatoid arthritis

 D

Salivary gland enlargement

Q. 3

All of the following are true about Primary Sjogren’s syndrome, except:

 A

May be seen in children

 B

Sensation of sand or gravel in eyes

 C

Associated with rheumatoid arthritis

 D

Salivary gland enlargement

Ans. C

Explanation:

Answer is C (Associated with Rheumatoid Arthritis):

Kelly’s Rheumatoid arthritis is associated with Secondary Sjogren’s Syndrome and not Primary Sjogren’s Syndrome.

Primary Sjogren’s Syndrome

No Connective Tissue /Chronic inflammatory disorder

Secondary Sjogren’s Syndrome

Underlying Connective Tissue / Chronic inflammatory disorder

 

Keratoconjunctivitis Sicca (Sensation of sand or gravel in eyes) and salivary gland enlargement are typical symptoms of Sjogren’s syndrome (Both Primary and Secondary). Primary Sjogren’s syndrome typically affects women in their middle age (Female to male ratio = 9:1) but it may occur at any age including childhood. Primary Sjogren’s syndrome

has been reported infrequently in children with onset as early as 5 years of age. The presence of symptoms and signs of Sjogren’s ‘s syndrome (Dry eyes; Dry mouth; Salivary Gland Enlargement) in the setting of another connective tissue disease or chronic inflammatory pathology like Rheumatoid Arthritis, SLE, Systemic Sclerosis by definition is termed as Secondary Sjogren’s Syndrome.

Quiz In Between


Q. 4

All of the following are features of Sjogren’s syndrome except:

 A

It is an autoimmune chronic inflammatory disease

 B

Typically occurs in women after the menopause

 C

In primary Sjogren’s syndrome, kerato­conjunctivitis sicca is associated with rheumatoid arthritis

 D

In secondary Sjogren’s syndrome, dry eye and/ or xerostomia (dry mouth) is associated with rheumatoid arthritis

Q. 4

All of the following are features of Sjogren’s syndrome except:

 A

It is an autoimmune chronic inflammatory disease

 B

Typically occurs in women after the menopause

 C

In primary Sjogren’s syndrome, kerato­conjunctivitis sicca is associated with rheumatoid arthritis

 D

In secondary Sjogren’s syndrome, dry eye and/ or xerostomia (dry mouth) is associated with rheumatoid arthritis

Ans. C

Explanation:

Ans. In primary Sjogren’s syndrome, kerato­conjunctivitis sicca is associated with rheumatoid arthritis


Q. 5

Regarding Sjogren’s syndrome, all are true except:

September 2010

 A

Keratoconjuctivitis sicca

 B

Rheumatoid arthritis

 C

Epiphora

 D

Autoimmune in nature

Q. 5

Regarding Sjogren’s syndrome, all are true except:

September 2010

 A

Keratoconjuctivitis sicca

 B

Rheumatoid arthritis

 C

Epiphora

 D

Autoimmune in nature

Ans. C

Explanation:

Ans. C: Epiphora

SjOgren’s syndrome (also known as “Mikulicz disease” and “Sicca syndrome”, is a systemic autoimmune disease in which immune cells attack and destroy the exocrine glands that produce tears and saliva

SjOgren’s syndrome can exist as a disorder in its own right (Primary Sjogren’s syndrome) or it may develop years after the onset of an associated rheumatic disorder such as rheumatoid arthritis, systemic lupus erythematosus, scleroderma, primary biliary cirrhosis etc. (Secondary SjOgren’s syndrome)


Q. 6

True regarding Sjogren’s syndrome are all of the following except:    

September 2009

 A

Autoimmune condition

 B

Males are commonly affected

 C

Progressive destruction of lacrimal and salivary gland

 D

No single laboratory investigation is pathognomic

Q. 6

True regarding Sjogren’s syndrome are all of the following except:    

September 2009

 A

Autoimmune condition

 B

Males are commonly affected

 C

Progressive destruction of lacrimal and salivary gland

 D

No single laboratory investigation is pathognomic

Ans. B

Explanation:

Ans. B: Males are commonly affected

SjOgren’s Syndrome (SS) is a systemic autoimmune disease characterised by lymphocytic infiltration, acinar cell destruction and proliferation of duct epithelium in all salivary and larimal gland tissue.

Extra glandular involvement of muscles, blood vessels, lungs, kidneys may also occur.

Females are affected more than the males

It may be primary and secondary (when associated with other connective tissue diseases). There is a risk of progression to lymphoid malignancy.

Dry mouth, dry eyes and arthritis/arthralgia are the 3 common presenting features.

Of the extraarticular manifestations, Raynaud’s phenomena is the most common skin manifestation seen in 35% of patients. Vasculitis has been reported in 5% of patients with Sjogren’s syndrome. This includes small vessel leucocytoclastic vasculitis and medium vessel necrotising vasculitis.

Distal RTA may be silent or lead to renal stones, nephrocalcinosis and compromised renal function. Hypergammaglobulinemia may be due to polyclonal activation of B cells.

The diagnosis is base on the history as no single laboratory investigation is pathognomic of either primary or secondary Sjogren’s syndrome


Q. 7

Development of Lymphoma in Sjogren’s syndrome is suggested by all of the following except

 A

Persistent parotid gland enlargement

 B

Cyoglobilinemia

 C

Leukopenia

 D

High C4 compement levels

Q. 7

Development of Lymphoma in Sjogren’s syndrome is suggested by all of the following except

 A

Persistent parotid gland enlargement

 B

Cyoglobilinemia

 C

Leukopenia

 D

High C4 compement levels

Ans. D

Explanation:

Ans. is ‘d’ i.e., High C4 complement levels

  • Lymphoa is a well-known complication of Sjogren’s syndrome Most lymphomas are extra-nodal, low grade marginal B cell lymphomas.
  • Development of Lymphoma in Sjogren’s syndrome is suggested by low C4 complement levels.

Lymphoma in Sjogren’s syndrome

The development ofLymphomas in patients with Sjogren syndrome is suggested by : –

  • Persistent parotid gland enlargement
  • Purpura
  • Leukopenia
  • Cryoglobulinemia
  • Low C4 complement levels

Quiz In Between



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