SlideShare una empresa de Scribd logo
1 de 34
Prof.S.SUNDAR’S unit Dr.G.Rengaraj.PG
History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Examination ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
DD of sicca symptoms ,[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]
 
INVESTIGATIONS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Inv. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ophthal op. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
INV. ,[object Object],[object Object],[object Object],[object Object]
Biopsy  ,[object Object],[object Object],[object Object]
Inv. ,[object Object],[object Object],[object Object],[object Object]
 
Sjogren’s syndrome ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
criteria ,[object Object],[object Object],[object Object],[object Object]
CRITERIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Criteria  ,[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]
Picture showing DRY,ERYTHEMATOUS  ORAL  MUCOSA  of the pt ,[object Object]
 
Sjogren’s ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pathogenesis  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical manifestations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DD of sjogren’s HIV infection & sicca syndrome sjogren’s syn. sarcoidosis Age predominantly young males predominantly in middle-aged women invariable Auto-antibodies - Presence of autoantibodies to Ro/SS-A and/or La/SS-B  -  Histology lymphoid infiltrates of salivary glands by CD8+ lymphocytes Lymphoid infiltrates of salivary glands by CD4+ lymphocytes  granulomas in salivary glands Genetics  Associated with HLA-DR5 Associated with HLA-DR3 & DRw52 unknown  Serology  Positive tests for HIV  Neg. tests Neg. tests
HIV & Sjogren’s ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Secondary sjogren’s ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 

Más contenido relacionado

La actualidad más candente

Systemic Lupus Erythematosis
Systemic Lupus ErythematosisSystemic Lupus Erythematosis
Systemic Lupus ErythematosisJayakrishnan MP
 
Case presentation in Dermatology erythrodermic psoriasis
Case presentation in Dermatology erythrodermic psoriasisCase presentation in Dermatology erythrodermic psoriasis
Case presentation in Dermatology erythrodermic psoriasisraheef
 
Systemic sclerosis..scleroderma
Systemic sclerosis..sclerodermaSystemic sclerosis..scleroderma
Systemic sclerosis..sclerodermaPraveen Nagula
 
Long case presentation in clinical exams.
Long case presentation in clinical exams.Long case presentation in clinical exams.
Long case presentation in clinical exams.Imad Hassan
 
Acute cholecystitis case-based discussion
Acute cholecystitis case-based discussionAcute cholecystitis case-based discussion
Acute cholecystitis case-based discussionAbdullah Bin Eid
 
chronic liver disease
chronic liver diseasechronic liver disease
chronic liver diseaseSamia Farhin
 
Approach to history taking in a patient with fever
Approach  to  history  taking  in  a  patient  with  feverApproach  to  history  taking  in  a  patient  with  fever
Approach to history taking in a patient with feverReina Ramesh
 
Behcet’s disease
Behcet’s diseaseBehcet’s disease
Behcet’s diseaseimangalal
 
History & examination of edema
History & examination of edemaHistory & examination of edema
History & examination of edemaAbino David
 
CASE OF FEVER WITH LYMPHADENOPATHY, SPLENOMEGALY AND PANCYTOPENIA
CASE OF FEVER WITH LYMPHADENOPATHY,   SPLENOMEGALY AND PANCYTOPENIACASE OF FEVER WITH LYMPHADENOPATHY,   SPLENOMEGALY AND PANCYTOPENIA
CASE OF FEVER WITH LYMPHADENOPATHY, SPLENOMEGALY AND PANCYTOPENIAGaurav Jain
 
Case study on Varicose Veins & Venous Ulcers
Case study on Varicose Veins & Venous UlcersCase study on Varicose Veins & Venous Ulcers
Case study on Varicose Veins & Venous UlcersAbhineet Dey
 

La actualidad más candente (20)

Systemic Lupus Erythematosis
Systemic Lupus ErythematosisSystemic Lupus Erythematosis
Systemic Lupus Erythematosis
 
Behcet's disease
 Behcet's disease Behcet's disease
Behcet's disease
 
Case presentation in Dermatology erythrodermic psoriasis
Case presentation in Dermatology erythrodermic psoriasisCase presentation in Dermatology erythrodermic psoriasis
Case presentation in Dermatology erythrodermic psoriasis
 
Lichen planus
Lichen planusLichen planus
Lichen planus
 
Sjogren syndrome by aseem
Sjogren syndrome by aseemSjogren syndrome by aseem
Sjogren syndrome by aseem
 
Systemic sclerosis..scleroderma
Systemic sclerosis..sclerodermaSystemic sclerosis..scleroderma
Systemic sclerosis..scleroderma
 
Nikolsky sign
Nikolsky signNikolsky sign
Nikolsky sign
 
Long case presentation in clinical exams.
Long case presentation in clinical exams.Long case presentation in clinical exams.
Long case presentation in clinical exams.
 
Lichen planus
Lichen planusLichen planus
Lichen planus
 
History taking
History takingHistory taking
History taking
 
Acute cholecystitis case-based discussion
Acute cholecystitis case-based discussionAcute cholecystitis case-based discussion
Acute cholecystitis case-based discussion
 
chronic liver disease
chronic liver diseasechronic liver disease
chronic liver disease
 
Leprosy
LeprosyLeprosy
Leprosy
 
Approach to history taking in a patient with fever
Approach  to  history  taking  in  a  patient  with  feverApproach  to  history  taking  in  a  patient  with  fever
Approach to history taking in a patient with fever
 
Behcet’s disease
Behcet’s diseaseBehcet’s disease
Behcet’s disease
 
Erythema nodosum
Erythema nodosumErythema nodosum
Erythema nodosum
 
History & examination of edema
History & examination of edemaHistory & examination of edema
History & examination of edema
 
Lichen planus
Lichen planusLichen planus
Lichen planus
 
CASE OF FEVER WITH LYMPHADENOPATHY, SPLENOMEGALY AND PANCYTOPENIA
CASE OF FEVER WITH LYMPHADENOPATHY,   SPLENOMEGALY AND PANCYTOPENIACASE OF FEVER WITH LYMPHADENOPATHY,   SPLENOMEGALY AND PANCYTOPENIA
CASE OF FEVER WITH LYMPHADENOPATHY, SPLENOMEGALY AND PANCYTOPENIA
 
Case study on Varicose Veins & Venous Ulcers
Case study on Varicose Veins & Venous UlcersCase study on Varicose Veins & Venous Ulcers
Case study on Varicose Veins & Venous Ulcers
 

Destacado

Sjögren's syndrome
Sjögren's  syndromeSjögren's  syndrome
Sjögren's syndromeJaya Yadav
 
Sjogren Syndrome- a complex CNS disease
Sjogren Syndrome- a complex CNS disease Sjogren Syndrome- a complex CNS disease
Sjogren Syndrome- a complex CNS disease Diana Girnita
 
Sjogren’s syndrome
Sjogren’s syndromeSjogren’s syndrome
Sjogren’s syndromeDJ CrissCross
 
DIABETIC RETINOPATHY DEMYSTIFIED
DIABETIC RETINOPATHY DEMYSTIFIEDDIABETIC RETINOPATHY DEMYSTIFIED
DIABETIC RETINOPATHY DEMYSTIFIEDDINESH and SONALEE
 
Gluten intolerance and rheumatic diseases 5.2.14
Gluten intolerance and rheumatic diseases 5.2.14Gluten intolerance and rheumatic diseases 5.2.14
Gluten intolerance and rheumatic diseases 5.2.14IFSMED
 
Seropositive arthritis Rheumatoid and others
Seropositive arthritis Rheumatoid and othersSeropositive arthritis Rheumatoid and others
Seropositive arthritis Rheumatoid and othersArif S
 
Sjogren’s syndrome
Sjogren’s syndromeSjogren’s syndrome
Sjogren’s syndromeWaseem Khan
 
Diastolic heart failure
Diastolic heart failureDiastolic heart failure
Diastolic heart failureRajeel Imran
 
Approach To A Patient With Polyarthritis
Approach To A Patient With PolyarthritisApproach To A Patient With Polyarthritis
Approach To A Patient With PolyarthritisPramod Mahender
 
Principal basics of the echocardiogram diastolic dysfunction and left ventric...
Principal basics of the echocardiogram diastolic dysfunction and left ventric...Principal basics of the echocardiogram diastolic dysfunction and left ventric...
Principal basics of the echocardiogram diastolic dysfunction and left ventric...Dung le Huu
 

Destacado (20)

Sjogren's syndrome
Sjogren's syndromeSjogren's syndrome
Sjogren's syndrome
 
Sjögren syndrome
Sjögren syndromeSjögren syndrome
Sjögren syndrome
 
SJOGREN'S SYNDROME
SJOGREN'S SYNDROMESJOGREN'S SYNDROME
SJOGREN'S SYNDROME
 
Sjogren syndrome
Sjogren syndromeSjogren syndrome
Sjogren syndrome
 
Sjögren's syndrome
Sjögren's  syndromeSjögren's  syndrome
Sjögren's syndrome
 
Sjogren Syndrome- a complex CNS disease
Sjogren Syndrome- a complex CNS disease Sjogren Syndrome- a complex CNS disease
Sjogren Syndrome- a complex CNS disease
 
Sjogrens's Syndrome
Sjogrens's SyndromeSjogrens's Syndrome
Sjogrens's Syndrome
 
Sjogren’s syndrome
Sjogren’s syndromeSjogren’s syndrome
Sjogren’s syndrome
 
DIABETIC RETINOPATHY DEMYSTIFIED
DIABETIC RETINOPATHY DEMYSTIFIEDDIABETIC RETINOPATHY DEMYSTIFIED
DIABETIC RETINOPATHY DEMYSTIFIED
 
Gluten intolerance and rheumatic diseases 5.2.14
Gluten intolerance and rheumatic diseases 5.2.14Gluten intolerance and rheumatic diseases 5.2.14
Gluten intolerance and rheumatic diseases 5.2.14
 
A Case of Peripheral Neuropathy
A Case of Peripheral NeuropathyA Case of Peripheral Neuropathy
A Case of Peripheral Neuropathy
 
Seropositive arthritis Rheumatoid and others
Seropositive arthritis Rheumatoid and othersSeropositive arthritis Rheumatoid and others
Seropositive arthritis Rheumatoid and others
 
Sjogren’s syndrome
Sjogren’s syndromeSjogren’s syndrome
Sjogren’s syndrome
 
Diastolic heart failure
Diastolic heart failureDiastolic heart failure
Diastolic heart failure
 
Flexor Tenosynovitis
Flexor TenosynovitisFlexor Tenosynovitis
Flexor Tenosynovitis
 
A Case of Dermatomyositis
A Case of DermatomyositisA Case of Dermatomyositis
A Case of Dermatomyositis
 
Limbal stem cell deficiency
Limbal stem cell deficiencyLimbal stem cell deficiency
Limbal stem cell deficiency
 
Approach To A Patient With Polyarthritis
Approach To A Patient With PolyarthritisApproach To A Patient With Polyarthritis
Approach To A Patient With Polyarthritis
 
Principal basics of the echocardiogram diastolic dysfunction and left ventric...
Principal basics of the echocardiogram diastolic dysfunction and left ventric...Principal basics of the echocardiogram diastolic dysfunction and left ventric...
Principal basics of the echocardiogram diastolic dysfunction and left ventric...
 
Diastolic dysfunction
Diastolic dysfunctionDiastolic dysfunction
Diastolic dysfunction
 

Similar a A Case of Sjogren's Syndrome

Similar a A Case of Sjogren's Syndrome (20)

Systemic Lupus Erythematosus
Systemic Lupus ErythematosusSystemic Lupus Erythematosus
Systemic Lupus Erythematosus
 
Case discussion
Case discussionCase discussion
Case discussion
 
Russell Waddell: Syphilis Presentation and Treatment
Russell Waddell: Syphilis Presentation and TreatmentRussell Waddell: Syphilis Presentation and Treatment
Russell Waddell: Syphilis Presentation and Treatment
 
Sjogren
SjogrenSjogren
Sjogren
 
Sjogrens
Sjogrens Sjogrens
Sjogrens
 
Sjogren-Parotitis
Sjogren-ParotitisSjogren-Parotitis
Sjogren-Parotitis
 
Neonatal sepsis
Neonatal sepsisNeonatal sepsis
Neonatal sepsis
 
cerebral toxoplasmosis
cerebral toxoplasmosiscerebral toxoplasmosis
cerebral toxoplasmosis
 
Systemic lupus erythematosus
Systemic lupus erythematosusSystemic lupus erythematosus
Systemic lupus erythematosus
 
syphilis.pptx
syphilis.pptxsyphilis.pptx
syphilis.pptx
 
Autoimmune polyendocrine syndromes (APS)pptx
Autoimmune  polyendocrine syndromes (APS)pptxAutoimmune  polyendocrine syndromes (APS)pptx
Autoimmune polyendocrine syndromes (APS)pptx
 
sjogren's syndrome clinical features,diagnosis,management
sjogren's syndrome clinical features,diagnosis,managementsjogren's syndrome clinical features,diagnosis,management
sjogren's syndrome clinical features,diagnosis,management
 
SLE grand round
SLE grand roundSLE grand round
SLE grand round
 
Kawasakii
KawasakiiKawasakii
Kawasakii
 
Systemic Lupus-erythmatosus a detailed review.pdf
Systemic Lupus-erythmatosus  a detailed review.pdfSystemic Lupus-erythmatosus  a detailed review.pdf
Systemic Lupus-erythmatosus a detailed review.pdf
 
DrRobertFoxUtahSSF
DrRobertFoxUtahSSFDrRobertFoxUtahSSF
DrRobertFoxUtahSSF
 
Lab diagnosis autoimmune disease
Lab diagnosis autoimmune diseaseLab diagnosis autoimmune disease
Lab diagnosis autoimmune disease
 
Leukaemia 5 july 2010 dr. gm
Leukaemia 5 july 2010 dr. gmLeukaemia 5 july 2010 dr. gm
Leukaemia 5 july 2010 dr. gm
 
Psgn nephrotic syndrome
Psgn nephrotic syndromePsgn nephrotic syndrome
Psgn nephrotic syndrome
 
jama_siegel_2024_rv_240007_1712240383.96073.pptx
jama_siegel_2024_rv_240007_1712240383.96073.pptxjama_siegel_2024_rv_240007_1712240383.96073.pptx
jama_siegel_2024_rv_240007_1712240383.96073.pptx
 

Más de Stanley Medical College, Department of Medicine

Más de Stanley Medical College, Department of Medicine (20)

Interpretation of Liver Function Tests
Interpretation of Liver Function TestsInterpretation of Liver Function Tests
Interpretation of Liver Function Tests
 
A Case of Sheehan's Syndrome
A Case of Sheehan's SyndromeA Case of Sheehan's Syndrome
A Case of Sheehan's Syndrome
 
Imaging: Cortical Vein Thrombosis
Imaging: Cortical Vein ThrombosisImaging: Cortical Vein Thrombosis
Imaging: Cortical Vein Thrombosis
 
ECG: Findings in CNS disorders
ECG: Findings in CNS disordersECG: Findings in CNS disorders
ECG: Findings in CNS disorders
 
A Case of Arrhythmogenic Right Ventricular Dysplasia - ARVD
A Case of Arrhythmogenic Right Ventricular Dysplasia - ARVDA Case of Arrhythmogenic Right Ventricular Dysplasia - ARVD
A Case of Arrhythmogenic Right Ventricular Dysplasia - ARVD
 
A Case of NASH with HYPOTHYROIDISM
A Case of NASH with HYPOTHYROIDISMA Case of NASH with HYPOTHYROIDISM
A Case of NASH with HYPOTHYROIDISM
 
IMAGING: NEUROCYSTICERCOSIS
IMAGING: NEUROCYSTICERCOSISIMAGING: NEUROCYSTICERCOSIS
IMAGING: NEUROCYSTICERCOSIS
 
ECG: Digitalis Effect / MAT / AF
ECG: Digitalis Effect / MAT / AFECG: Digitalis Effect / MAT / AF
ECG: Digitalis Effect / MAT / AF
 
Imaging: BOOP
Imaging: BOOPImaging: BOOP
Imaging: BOOP
 
ECG: Hypokalemia
ECG: HypokalemiaECG: Hypokalemia
ECG: Hypokalemia
 
A Case of Idiopathic Pulmonary Hypertension
A Case of Idiopathic Pulmonary HypertensionA Case of Idiopathic Pulmonary Hypertension
A Case of Idiopathic Pulmonary Hypertension
 
A Case of Schmidt Syndrome
A Case of Schmidt Syndrome A Case of Schmidt Syndrome
A Case of Schmidt Syndrome
 
A Case of Rodenticide Poisoning
A Case of Rodenticide PoisoningA Case of Rodenticide Poisoning
A Case of Rodenticide Poisoning
 
A Case of Emphysematous Pylonephritis
A Case of Emphysematous Pylonephritis A Case of Emphysematous Pylonephritis
A Case of Emphysematous Pylonephritis
 
Imaging: Multiple Pulmonary Cavitary Lesions
Imaging: Multiple Pulmonary Cavitary LesionsImaging: Multiple Pulmonary Cavitary Lesions
Imaging: Multiple Pulmonary Cavitary Lesions
 
ECG: Atrial Dissociation
ECG: Atrial DissociationECG: Atrial Dissociation
ECG: Atrial Dissociation
 
A Case of Hepato-Pulmonary Syndrome
A Case of Hepato-Pulmonary SyndromeA Case of Hepato-Pulmonary Syndrome
A Case of Hepato-Pulmonary Syndrome
 
A Case of Thalassemia
A Case of ThalassemiaA Case of Thalassemia
A Case of Thalassemia
 
A Case of Renal Amyloidosis
A Case of Renal AmyloidosisA Case of Renal Amyloidosis
A Case of Renal Amyloidosis
 
CXR: Silico-Tuberculosis
CXR: Silico-TuberculosisCXR: Silico-Tuberculosis
CXR: Silico-Tuberculosis
 

Último

Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service AvailableTrichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service AvailableGENUINE ESCORT AGENCY
 
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...Namrata Singh
 
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...khalifaescort01
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Availableperfect solution
 
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...Sheetaleventcompany
 
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...chennailover
 
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In AhmedabadGENUINE ESCORT AGENCY
 
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...aartirawatdelhi
 
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...parulsinha
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...chandars293
 
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...Anamika Rawat
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeCall Girls Delhi
 
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Ishani Gupta
 
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...chennailover
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...chandars293
 
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on WhatsappMost Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on WhatsappInaaya Sharma
 

Último (20)

Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
 
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service AvailableTrichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
 
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
 
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
 
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
 
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
 
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
 
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
 
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
 
🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...
🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...
🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
 
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
 
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
 
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
 
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
 
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on WhatsappMost Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
 
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
 

A Case of Sjogren's Syndrome

  • 2.
  • 3.
  • 4.
  • 5.
  • 6.  
  • 7.
  • 8.  
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.  
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.  
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28. DD of sjogren’s HIV infection & sicca syndrome sjogren’s syn. sarcoidosis Age predominantly young males predominantly in middle-aged women invariable Auto-antibodies - Presence of autoantibodies to Ro/SS-A and/or La/SS-B - Histology lymphoid infiltrates of salivary glands by CD8+ lymphocytes Lymphoid infiltrates of salivary glands by CD4+ lymphocytes granulomas in salivary glands Genetics Associated with HLA-DR5 Associated with HLA-DR3 & DRw52 unknown Serology Positive tests for HIV Neg. tests Neg. tests
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.