Sjögren's syndrome
may develop into systemic disease and eventually evolve into a lymphoproliferative disease - malignant lymphoma
also look for increase in dental caries and parotid enlargement
For Dx
Schirmer's test - decreased tear production
Rose Bengal stain - corneal ulcerations
ANA positive and specifically anti-Ro(SSA) and anti-La (SSB)
Biopsy shows lymphocytic infiltration of the salivary glands
Tx : no cure, artificial tears
Pilocarpine and cevimeline increase acetylcholine and increase tear and saliva production
Guillain-Barre
$ - The most well-described antecedent infection is the bacterium
Campylobacter jejuni
, Char: by progressive weakness in legs and often arms, and areflexia (the absence of deep tendon reflexes)
Supportive Features: progression of symptoms over days to four weeks, relative symmetry of symptoms, mild sensory symptoms or signs, cranial nerve involvement (especially bilateral weakness of facial muscles), autonomic dysfunction, pain (often present), high concentration of protein in CSF, and typical electrodiagnostic features
Myasthenia Gravis - caused by circulating antibodies that block acetylcholine receptors at the postsynaptic neuromuscular junction