Sjogren-Parotitis

Sialadenitis/Parotitis/Sjogren’s Vincent Steniger, D.M.D 4-17-08

Outline ,[object Object],[object Object],[object Object],[object Object]

Chief Complaint ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

History of Present Illness ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Past Medical Hx (SHH) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EOE/ IOE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Sialadentitis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Sialadentitis: Etiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Parotitis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Parotitis: Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Overall Treatment for Parotitis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Mumps: (Viral Parotitis) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Mumps: Clinical Features ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical Features- continued ,[object Object],[object Object],[object Object],[object Object],[object Object]

Mumps: Histopathology ,[object Object],[object Object]

Mumps: Treatment ,[object Object],[object Object],[object Object],[object Object]

Sjogren’s Syndrome ,[object Object],[object Object]

Sjogren’s Syndrome ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Sjogren’s Syndrome: Who is effected? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Sjogren's Syndrome: Age of Onset ,[object Object],0 5 10 15 20 25 30 35 40 45 1-10 11-20 21-30 31-40 41-50 51-60 61-70 71-80 81-90 AGE % OF PATIENTS At diagnosis Onset

Sjogren’s Syndrome: Clinically ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

“ Crocodile Skin” Tongue, Carious Teeth

Tests and Studies: Scintigraphy ,[object Object],0.00 0.42 1.60 Salivary flow rate (ml/5-min/gland) Severe Mild None Degree of xerostomia Marked involvement Moderate involvement Normal Scintigraphy diagnosis

Scintigraphy: Continued ,[object Object]

Tests and Studies: Schirmer’s Test ,[object Object],[object Object],[object Object],[object Object]

Tests and Studies: Serology 30 Cryoglobulins (type II) 60 Ro/SSA 80 Rheumatoid factors (Igs) 95 a-fodrin 30 La/SSB % positive Autoantibodies

Tests and Studies: Salivary Gland Biopsy ,[object Object]

Tests and Studies: Salivary Flow Rate ,[object Object],[object Object]

Sjogren’s Syndrome: Exclusion Criteria ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Sjogren’s Syndrome: Differential Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Sjogren's Syndrome Algorithm for the diagnosis If positive Sjogren's Syndrome Dry mouth Dry eyes Salivary gland enlargement Raynaud’s phenomenon Purpura Renal tubular acidosis or or Eye & salivary gland tests Serology If any positive

Sjogren’s Syndrome: Pathophysiology ,[object Object],[object Object]

Pathophysiology: Continued ,[object Object],[object Object],[object Object],[object Object],[object Object]

Parotitis/Sjogren’s: Histology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Sjogren’s Syndrome: Systemic Manifestations Skopouli et al., Semin Arthritis Rheum. 2000, 29:296 30 Raynaud’s phenomenon 60 Arthralgia/arthritis 10 (25) Lung involvement (increased liver enzymes) 15 (1) Purpura/Vasculitis 1 Muscle involvement 5 Liver involvement 8 (25) Kidney involvement (Interstitial Nephritis/Glomerulonephritis) Frequency (%) Systemic manifestations

[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],Why Do the Study?

Purpose of the Study ,[object Object]

Materials and Methods: Subjects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Materials and Methods: Methods: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

A Review… ,[object Object],[object Object],[object Object],[object Object]

Results: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Conclusion ,[object Object],[object Object],[object Object],[object Object]

Case Study ,[object Object],[object Object],[object Object],[object Object]

Case Subject ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],Salivary Function and Biopsy

Conclusion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Case Patient: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

To Do For The Patient: ,[object Object],[object Object],[object Object],[object Object],[object Object]

Sjogren’s Syndrome: Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment: Continued ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Sjogren-Parotitis

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