====== Sjögren Syndrome ======
Autoimmune disease of that affects the lacrimal and salivary glands causing dryness of the ocular surface and mucous membranes. It often seriously affects other organ systems, such as the lungs, kidneys, and nervous system. 

===== When to Suspect =====
  * Dry Mouth, fatigue, joint/muscle pain
  * Other autoimmune diseases: Rheumatoid Arthritis, Systemic Lupus Erythematosis, Scleroderma, Undifferentiated connective tissue disease, Reynaud, Hashimoto, Chron's Disease
  * Family History of autoimmune diseases
  * [[schirmer_test|Schirmer test]] (unanesthetized) ≤ 5mm in 5 minutes
  * Ocular Surface Staining 
    * [[ocular_surface_staining_score|OSS > 3-5]]
    * Conjunctival lissamine green staining

===== Diagnostic Criteria 2016 =====

|Item|Weight/Score|
|Anti-SSA / Ro antibody positivity|3|
|Focal lymphocytic sialadenitis with a focus score of ≥ 1 foci / 4 mm²|3|
|Abnormal ocular staining score of ≥ 5 (or van Bijsterveld score of ≥ 4) |1|
|Shirmer's test (no local anesthetic) result of ≤ 5mm / 5 minutes|1|
|Unstimulated salivary flow rate of ≤ 0.1 ml/minute|1| 
Source: {{ ::shiboski_-_2016_american_college_of_rheumatology_european_league_against_rheumatism.pdf |Shiboski et. al. 2016 American College of Rheumatology Classification Criteria for Primary Sjögren's Syndrome}}

{{tag>syndrome}}