Sjogren Syndrome

Anesthesia Implications

Anesthesia Implications

Dry/Dysfunctional exocrine glands – results in excessively dry secretions. This leads to mucous plugs and severely dry airways. Make sure to humidify delivered oxygen and suction sufficiently to prevent plugs. Furthermore, consider lubricating the eyes to prevent corneal damage intraoperatively.

Drugs – Where possible, avoid drugs such as glycopyrrolate, which will further dry secretions.

Pathophysiology

Autosomal recessive autoimmune disorder – results in the destruction and dysfunction of exocrine glands. It is thought that genetic and environmental factors play a role in the development of this syndrome.

Symptoms – Urticarial vasculitis, positive rheumatoid factor, keratoconjunctivitis sicca (dry eyes), xerostomia (dry mouth).

Diagnosis – Eye tests, salivary gland function tests, ultrasonography of salivary glands, blood tests, and lip biopsies can all be used to diagnose sjogren syndrome. These tests are used to test the function of exocrine glands primarily in the eyes and mouth.

Comorbidities – it is not uncommon for this disorder to be in conjunction with systemic lupus erythematosus (SLE), rheumatoid arthritis, or scleroderma

Potential problems – patients with this syndrome are at higher risk to develop interstitial pneumonitis, interstitial nephritis, vasculitis, nerve damage, anemia, and thyroid abnormalities.

References

Hines. Stoelting’s anesthesia and co-existing disease. 7th edition. 2018.
UptoDate. Retrieved from www.uptodate.com. 2020.