wiki:autoimmune:sjogrens

Sjogrens Syndrome

autoimmune disease
- Ab's to the Ro/SSA and La/SSB antigens,(which are also found in other autoimmune diseases) cryoglobulinemia, hypocomplementemia
- propensity to develop non-Hodgkin lymphoma
often diagnosed during Ix of neuropathies, nephropathies, interstitial pneumonitis, hematologic abnormalities, lymphoproliferative changes
mild to moderate disease sometimes with lack of salivary involvement and more extra-salivary presentation

chronic autoimmune disease of unknown cause that can affect virtually any organ of the body.
Immunologic abnormalities, esp of antinuclear antibodies (ANA).
variable clinical features ranging from mild joint and skin involvement to life-threatening kidney, haematologic, or CNS involvement
fatigue, fever, myalgia and weight changes (both LOW and weight gain with fluid shifts assoc with low Alb)
Arthritis and arthralgias in over 90% - moderately painful, usually does not cause erosion, and rarely deforming
muco-cutaneous changes - highly variable but butterfly rash on face = common, and photosensitive rashes Painless ulcers
vasculitis including Raynaud's
thrombo-embolic disorders - both arterial and venous circulation
GI, resp, CNS, blood dyscrasias

aside from routine bloods, which may be abnormal, other supportive tests include:

Serum protein electrophoresis esp if hypergammaglobulinemia - suggestive of systemic inflammatory process
ANA (ideally by indirect immunofluorescence testing) - usually +ve in all SLE patients at some time. If +ve should then test for - anti-dsDNA, anti-Smith (anti-Sm), Ro/SSA, La/SSB, and U1 ribonucleoprotein (RNP)
Anti-double-stranded DNA (anti-dsDNA)
Antiphospholipid antibodies (lupus anticoagulant [LA], immunoglobulin [Ig] G and IgM anticardiolipin [aCL] antibodies, and IgG and IgM anti-beta2-glycoprotein [GP] 1)
C3 and C4 or CH50 complement levels
Erythrocyte sedimentation rate (ESR) and/or C-reactive protein (CRP) levels
Urine protein-to-creatinine ratio