Medical Emergencies · single question
A patient has positive SSA antibodies, dry eyes, and xerostomia. Dentist applies pressure on the parotid gland with no saliva expressed. What is the diagnosis?
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Correct answer: A. Sjögren's Syndrome
Sjögren's Syndrome (A). Classic diagnostic triad:
• Xerostomia (dry mouth) — parotid gland fibrosis → no saliva on palpation
• Xerophthalmia (dry eyes — keratoconjunctivitis sicca)
• Positive SSA (anti-Ro) antibodies — most specific serological marker
2016 ACR/EULAR Criteria for Primary SS:
• Lip biopsy: focal lymphocytic sialadenitis (score ≥1)
• Anti-SSA/Ro positive
• Schirmer's test <5mm/5min (dry eyes)
• Unstimulated whole saliva <0.1 mL/min
• Ocular staining score ≥5
• Dental management: xylitol products, saliva substitutes, fluoride varnish, pilocarpine (muscarinic agonist — stimulates residual secretion), cevimeline, treat xerostomia-related caries aggressively.
• Xerostomia (dry mouth) — parotid gland fibrosis → no saliva on palpation
• Xerophthalmia (dry eyes — keratoconjunctivitis sicca)
• Positive SSA (anti-Ro) antibodies — most specific serological marker
2016 ACR/EULAR Criteria for Primary SS:
• Lip biopsy: focal lymphocytic sialadenitis (score ≥1)
• Anti-SSA/Ro positive
• Schirmer's test <5mm/5min (dry eyes)
• Unstimulated whole saliva <0.1 mL/min
• Ocular staining score ≥5
• Dental management: xylitol products, saliva substitutes, fluoride varnish, pilocarpine (muscarinic agonist — stimulates residual secretion), cevimeline, treat xerostomia-related caries aggressively.
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