Levocarnitine for Keratoconjunctivitis Sicca in Sjogren's Syndrome

Author(s):  
Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1260
Author(s):  
Sneha Centala ◽  
Joyce H. Park ◽  
Diana Girnita

Sjogren’s syndrome is classically characterized by symptoms of keratoconjunctivitis sicca and xerostomia, secondary to lymphocytic infiltration of the salivary and lacrimal glands. Cutaneous findings of this disease are infrequently discussed and thus rarely considered among patients without the typical symptomatology. However, these patients can develop xerosis, alopecia, vitiligo, papular or nodular lesions, or cutaneous vasculitis. A 56-year-old Asian female presented with intermittent cutaneous erythematous lesions of her bilateral pinna and preauricular areas. Despite initial symptom presentation causing concern for tumid lupus versus cutaneous T cell lymphoma versus relapsing polychondritis, extensive serologic and histopathologic workup eventually indicated a likely diagnosis of Sjogren’s syndrome. This case brings to light that Sjogren’s syndrome is truly a multi-systemic disease and can present with primarily extra glandular cutaneous symptoms. When approaching the workup of a new patient, it is absolutely vital to maintain a broad differential and keep in mind that overlap syndromes among multiple autoimmune diseases do exist as well.


1997 ◽  
Vol 81 (6) ◽  
pp. 435-438 ◽  
Author(s):  
A A Kruize ◽  
O P van Bijsterveld ◽  
R J Hene ◽  
P C M de Wilde ◽  
T E W Feltkamp ◽  
...  

Author(s):  
Brittney M. Brady ◽  
Michelle K. Man

Background: Sjogren’s syndrome is a chronic, systemic autoimmune disorder, which often results in significant ocular surface disease. Dry eye associated with Sjogren’s syndrome is a multifactorial disease which leads to decreased function of the lacrimal glands and altered tear composition. There currently are numerous anti-inflammatory methods used for treatment of this disease. Case Report: This case report will focus on the use of amniotic membrane placement and autologous serum tears to facilitate a successful scleral contact lens fit allowing for reduced ocular inflammation and discomfort associated with Keratoconjunctivitis sicca due to Sjogren’s syndrome. Conclusion: Clinical management of keratoconjunctivitis sicca due to Sjogren’s syndrome can be challenging. Diagnosis often requires numerous in office testing including Schirmer I/II, TBUT, sodium fluorescein stain, and osmolarity. Such testing can be repeated over time to monitor for improvement with addition of each new therapy. Various treatment modalities such as topical lubricants, cyclosporine, autologous serum tears, or amniotic membranes have been proven to provide short-term benefits and excellent maintenance of symptoms. Utilizing such treatments to promote an ideal scleral contact lens fit provides lasting benefits of corneal clarity and stable vision.


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