Sjogren’s syndrome

Questions discussed in this category

How long are cholinergic agonists such as pilocarpine required to be held before doing tear assessments (ocular scoring and Schirmer’s) and sialography/salivary collection?

1 Answer available

In patients with sicca symptoms and positive SSA/SSB how often do you perform other diagnostic testing such as salivary gland ultrasound, biopsy, Shirmers, ocular staining, stimulated salivary flow, etc?

Is the diagnosis of Sjogren's mostly clinical in a patient with a consistent history and physical with positive serologies?

2 Answers available

Would you modify your treatment approach for treating an HPV-positive head and neck cancer in a patient with symptomatic Sjogren's?

1 Answer available

How do you approach work up for underlying rheumatologic disease in patients referred for chronic urticaria?

2 Answers available

How do you approach hypocomplementemia in Sjogren’s without features of lymphoma?

3 Answers available

What is your approach to maintenance treatment in a patient with Sjogren's who received rituximab for mononeuritis multiplex?

And how would you monitor response?

1 Answer available

What is your treatment approach to neurological Sjogrens disease with both peripheral neuropathy and transverse myelitis?

1 Answer available

How do you approach management of a patient with Sjogren's disease and lung mass biopsy revealing amyloidosis?

1 Answer available

Is monitoring for fetal heart block recommended in pregnant patients with only slightly elevated SSA?

2 Answers available

What is your approach to treatment of skin-limited cryoglobulinemic vasculitis in patients with Sjogren's syndrome who lack evidence of neurological or renal involvement?

1 Answer available

What is your approach to immunomodulatory treatment in patients with Sjogren's syndrome who have active serologies (i.e. elevated ESR, hypergammaglobulinemia, hypocomplementemia) but minimal symptoms?

3 Answers available

What is your approach to patients with severe sicca symptoms and history of B Cell lymphoma?

Patient has received treatment with Rituximab and is taking hydroxychloroquine.

1 Answer available

How do you approach monitoring for lymphoproliferative disease in Sjogren's patients?

2 Answers available

In patients with secondary Sjogren's how do you approach screening for lymphoproliferative malignancy?

What screening tests do you perform and at what intervals?

1 Answer available

What is your approach to management of chronic neutropenia in a patient with Sjogren’s who was recently diagnosed with metastatic endometrial cancer and plans to start chemotherapy?

ANC <500

1 Answer available

What is your approach to management of chronic recurrent parotitis in patients with Sjogren's Syndrome?

2 Answers available

What is your approach to management of persistent painless salivary gland swelling/sialadenitis in patients with Sjogren's?

No evidence of malignancy on serial CT scans.

2 Answers available

What is your preferred steroid sparing agent in the treatment of Sjögren associated LIP?

2 Answers available

How would you treat inflammatory arthritis in a patient with Sjogren's syndrome and ILD (on mycophenolate) that is not responsive to hydroxychloroquine?

1 Answer available

How would you manage tubulointerstitial nephritis and renal tubular acidosis (RTA) in a patient with Sjogren's who is pregnant?

2 Answers available

What is your approach to screening for complete heart block in an asymptomatic pregnant patient with negative SSA and positive SSB antibodies?

1 Answer available

How often should you screen for lymphoma in patients with primary Sjogren's syndrome?

1 Answer available

How do you approach management of a patient with lower extremity ulcers from livedoid vasculopathy with a history Sjogren’s and Factor V Leiden?

4 cutaneous biopsies with no evidence of vasculitis. Sjogren’s diagnosis based prominent sicca symptoms and a significantly elevated SSA.

2 Answers available

What is your approach to managing sicca symptoms in patients not responding or not tolerating conservative measures, pilocarpine, and cevimeline?

1 Answer available

In what circumstances do you pursue labial salivary gland biopsy in an asymptomatic patient with high titer ANA and positive SSA?

How do you risk stratify and monitor such patient for disease progression or organ involvement?

2 Answers available

When do you consider immunosuppression in patients with Sjogren's neuropathy?

3 Answers available

When performing salivary gland ultrasound for Sjogren's, what else do you include in the differential diagnosis?

1 Answer available

Do you continue to routinely screen for renal involvement in a patient with established Sjogren's syndrome who otherwise has only sicca symptoms?

1 Answer available

What is the diagnostic utility of ordering an "Early Sjogren's Syndrome Profile", which tests novel autoantibodies, to support a diagnosis of Sjogren's syndrome in patients who test negative for SSA/SSB?

1 Answer available

What is your approach to further workup, monitoring, and treatment of Sjogren's syndrome patients with positive cryoglobulins but no clear signs of vasculitis?

1 Answer available

Is there a role for immunosuppression in addition to standard PAH therapy in the management of pulmonary hypertension associated with primary Sjogrens syndrome?

Assuming other non CTD related causes for PAH have been excluded

1 Answer available

In what patients would you consider adjunctive IVIG for Sjogren's-related neuropathy?

2 Answers available

Do you assess baseline salivary gland function before starting treatment in patients with Sjogren's syndrome?

If so, what test do you use in clinical practice?

1 Answer available

How do you treat small fiber neuropathy associated with rheumatic conditions like Sjogren’s syndrome?

1 Answer available

How do you manage severe vaginal dryness and vulvodynia refractory to topical lubricants in patients with Sjogren's syndrome?

1 Answer available

Is chronic major salivary gland enlargement in a patient with Sjogren's an indication for immune-modulating therapy such as hydroxychloroquine or methotrexate?

1 Answer available

Are there any features that help differentiate Sjogren's-related CNS demyelinating plaques from multiple sclerosis in a patient with primary Sjogren's syndrome?

1 Answer available

What baseline work-up or "staging" do you do in patients with a new diagnosis of Sjogren's (i.e., PFT, cryoglobulins, complement, RF, UA)?

1 Answer available

Papers discussed in this category

RMD open, 2015

EULAR Sjögren's syndrome disease activity index (ESSDAI): a user guide.

Annals of the rheumatic diseases, 1999-04

Hydroxychloroquine treatment for primary Sjögren's syndrome: its effect on salivary and serum inflammatory markers.

Arthritis Care Res (Hoboken),

Biopsy-Proven Small-Fiber Neuropathy in Primary Sjögren's Syndrome: Neuropathic Pain Characteristics, Autoantibody Findings, and Histopathologic Features.

Rheumatology (Oxford), 2020 Feb 11

Vaginal dryness in primary Sjögren's syndrome: a histopathological case-control study.

Multiple sclerosis (Houndmills, Basingstoke, England), 2014-01

Limited utility of current MRI criteria for distinguishing multiple sclerosis from common mimickers: primary and secondary CNS vasculitis, lupus and Sjogren's syndrome.

Ann. Neurol., 2018 Feb 15

Central vein sign differentiates Multiple Sclerosis from central nervous system inflammatory vasculopathies.

J Am Dent Assoc,

Measuring salivary flow: challenges and opportunities.

Arthritis Rheumatol, 2016 Oct 26

2016 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Primary Sjögren's Syndrome: A Consensus and Data-Driven Methodology Involving Three International Patient Cohorts.

Ann Rheum Dis, 2019 Oct 31

EULAR recommendations for the management of Sjögren's syndrome with topical and systemic therapies.

Rheumatology (Oxford),

The management of Sjögren's syndrome: British Society for Rheumatology guideline scope.

Rheumatology (Oxford), 2019 Mar 05

Lymphomas complicating primary Sjögren's syndrome: from autoimmunity to lymphoma.

Chest, 2021 Feb

Consensus Guidelines for Evaluation and Management of Pulmonary Disease in Sjögren's.

J Am Dent Assoc, 2016 Jan 05

Clinical practice guidelines for oral management of Sjögren disease: Dental caries prevention.

The ocular surface, 2015 Jan 15

Clinical guidelines for management of dry eye associated with Sjögren disease.

Muscle & nerve, 2007-01

Rituximab treatment in patients with IVIg-dependent immune polyneuropathy: a prospective pilot trial.

Annals of neurology, 1990-03

Ataxic sensory neuropathy and dorsal root ganglionitis associated with Sjögren's syndrome.

Rheum Dis Clin North Am, 2017 Aug 23

Neurologic Manifestations of Primary Sjögren Syndrome.

Neurology,

Benefit of IVIG for long-standing ataxic sensory neuronopathy with Sjögren's syndrome. IV immunoglobulin.

Medicine (Baltimore),

Sjögren Sensory Neuronopathy (Sjögren Ganglionopathy): Long-Term Outcome and Treatment Response in a Series of 13 Cases.

Muscle Nerve, 2014 Dec 23

Sensory ganglionopathy with livedoid vasculopathy controlled by immunotherapy.

Clin Immunol, 2012 Oct 12

Novel autoantibodies in Sjogren's syndrome.

Rheumatol Int, 2014 Jun 05

Identification of lymphoma predictors in patients with primary Sjögren's syndrome: a systematic literature review and meta-analysis.

Rheumatol Ther, 2020 Dec 24

Renal Disease in Primary Sjögren's Syndrome.

Lupus, 2019 Jun 19

Prognostic markers of lymphoma development in primary Sjögren syndrome.

Ann Rheum Dis, 2011 Nov 09

Incidence of cancer in a nationwide population cohort of 7852 patients with primary Sjogren's syndrome in Taiwan.

Ann Acad Med Singap, 2012 Sep

A ten-year retrospective study on livedo vasculopathy in Asian patients.

Autoimmunity reviews, 2017-09

Clinical and pathologic implications of extending the spectrum of maternal autoantibodies reactive with ribonucleoproteins associated with cutaneous and now cardiac neonatal lupus from SSA/Ro and SSB/La to U1RNP.

Nat Rev Nephrol, 2015 Nov 16

Renal involvement in primary Sjögren syndrome.

Ear Nose Throat J, 2015 Jun

Intraductal infusion of steroids in patients with Sjögren syndrome to treat painful salivary swelling: Report of 2 cases.

Oral Dis, 2021 Mar 12

Eosinophilic sialodochitis: An emerging atopic condition.

Oral Dis, 2016 Dec 06

Eosinophilic sialodochitis: redefinition of 'allergic parotitis' and 'sialodochitis fibrinosa'.

Arthritis care & research, 2017-04

Treatment Guidelines for Rheumatologic Manifestations of Sjögren's Syndrome: Use of Biologic Agents, Management of Fatigue, and Inflammatory Musculoskeletal Pain.

Arthritis Rheumatol, 2016 Apr

Rheumatoid Factor and Disease Activity Are Independent Predictors of Lymphoma in Primary Sjögren's Syndrome.

Respiratory medicine, 2016-12

Azathioprine response in patients with fibrotic connective tissue disease-associated interstitial lung disease.

Mediterranean journal of rheumatology, 2022 Mar 31

Clinical Phenotype and Mechanisms of Leukopenia/Neutropenia in Patients with Primary Sjögren's Syndrome.

The Journal of allergy and clinical immunology, 2012 Feb 14

Chronic urticaria and autoimmunity: associations found in a large population study.

Annals of the rheumatic diseases, 2011 Sep 16

Efficacy of rituximab in primary Sjogren's syndrome with peripheral nervous system involvement: results from the AIR registry.

Arthritis Rheumatol, 2021 Jul

2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis.

Amyloid : the international journal of experimental and clinical investigation : the official journal of the International Society of Amyloidosis, 2021 Nov 12

Tissue biopsy for the diagnosis of amyloidosis: experience from some centres.

Radiographics : a review publication of the Radiological Society of North America, Inc, 2013 Nov-Dec

CT findings of thoracic manifestations of primary Sjögren syndrome: radiologic-pathologic correlation.

Journal of autoimmunity, 2012 Feb 06

Peripheral neuropathies in Sjögren's syndrome: a critical update on clinical features and pathogenetic mechanisms.

Rheumatology (Oxford, England), 2013 Oct 25

Systemic involvement in primary Sjogren's syndrome evaluated by the EULAR-SS disease activity index: analysis of 921 Spanish patients (GEAS-SS Registry).

Arthritis care & research, 2017 Oct 09

Subjective and Objective Measures of Dryness Symptoms in Primary Sjögren's Syndrome: Capturing the Discrepancy.

The Journal of rheumatology, 2021 May 01

Correlation Between Subjective and Objective Severity of Oral and Ocular Dryness in Primary Sjögren Syndrome.

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