Answer: GI manifestations may be present in up to 50% of patients with SLE. Anorexia, nausea, and vomiting are among the most common. Oral ulcerations (most commonly buccal erosions) were identified in 40% of one group of patients. Esophageal involvement, as esophagitis, esophageal ulceration, or esophageal dysmotility, seems to correlate with the presence of Raynaud’s [...]

Answer: Some consider this cutaneous eruption on a spectrum between chronic discoid lupus and acute cutaneous lupus. The lesions generally occur on the shoulders, upper chest, and neck and are symmetric and nonscarring. They can be annular and resemble psoriasis. Between 25% and 50% of patients have constitutional symptoms, and they may have circulating antibodies [...]

Answer: Symmetric, superficial, nonscarring annular lesions of the shoulders, upper arms, and back are the classic lesions of subacute cutaneous lupus. Nonscarring alopecia often occurs concurrently. Patients may or may not have circulating anti-Ro antibodies. Lesions are highly photosensitive. Reference: Harris ED, Budd RC, Firestein GS, et al (eds): Kelley’s Textbook of Rheumatology, 7th ed. [...]

Answer: Yes-non-Hodgkin’s lymphoma. The lymphomas are usually B cell-derived, and some patients also have serum protein spikes. The diagnosis of tumor may be difficult, given that the nonmalignant lymphoid infiltration of lymphocytes often simulates neoplasm (pseudolymphoma). Reference: Talal N: Sjögren’s syndrome and connective tissue diseases association with other immunologic disorders. In McCarty DJ, Koopman WJ [...]

Answer: If symptoms of an underlying connective tissue disease do not appear within 12 months of the keratoconjunctivitis sicca, the chances are approximately 10% that it will appear later in life. Reference: Talal N: Sjögren’s syndrome and connective tissue diseases association with other immunologic disorders. In McCarty DJ, Koopman WJ (eds): Arthritis and Allied Conditions, [...]

Answer: Many believe that Sjögren’s syndrome is underdiagnosed. The first step is to ask the appropriate historical questions. Inquiries about eye grittiness or the ability to eat crackers without water have been suggested as nonleading ways to ask about dryness. Schirmer’s test can document diminished output of the lacrimal glands. Likewise, biopsy of the salivary [...]

Answer: Sjögren’s syndrome is an inflammatory disease of exocrine glands manifested primarily by dryness of the eyes and mouth. It can occur as an isolated entity (primary Sjögren’s syndrome) or in association with another rheumatic disease, commonly RA or SLE (secondary Sjögren’s syndrome). Reference: Koopman WJ (ed): Arthritis and Allied Conditions: A Textbook of Rheumatology, [...]