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Salivary Gland

Question
72 out of 80
 

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



A Autoimmune condition

B Males are commonly affected

C Progressive destruction of lacrimal and salivary gland

D No single laboratory investigation is pathognomonic

Ans. B Males are commonly affected (Ref: Robbins 8/e p222; Bailey 26/e p737, 25/e p766; Harrison 18/e p2770-2772)

Sjogren Syndrome

• Chronic disease characterized by dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia) resulting from immunologically mediated destruction of the lacrimal and salivary glands,

• It occurs as an isolated disorder (primary form), also known as the sicca syndrome or more often in association with another autoimmune disease (secondary form)

• Rheumatoid arthritis is the MC associated disorder

Pathology

• Characterized by lymphocytic infiltration and fibrosis of the lacrimal and salivary glands".

• Earliest histologic finding in both the major and minor salivary glands is periductal and perivascular lymphocytic infiltration.

a. Most important antibodies: Directed against SS-A (Ro) and SS-B (La), which can be detected in 90% of patients (serologic markers? of the disease)

b. Patients with high titers of antibodies to SS-A are more likely to have early disease onset, longer disease duration, and extraglandular manifestations.

Clinical Features

• Occurs most commonly in women between the ages of 50 and 60.

• Characteristic symptoms: Keratoconjunctivitis and xerostomia

• Parotid gland enlargement is present in half of the patients?

• Extraglandular disease are seen in one third of patients

Diagnosis

• Biopsy of the lip (to examine minor salivary glands) is essential for the diagnosis of Sjögren syndromes,

Salivary Gland Flashcard List

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