Question

A middle-aged woman presents with dry eyes and dry mouth. Laboratory tests reveal positive anti-Ro (SSA) and anti-La (SSB) antibodies. What is the most likely underlying pathological mechanism?

• A. Destruction of exocrine glands by neutrophils
• B. IgE-mediated hypersensitivity reaction
• C. Lymphocytic infiltration and destruction of salivary and lacrimal glands
• D. Deposition of amyloid in salivary glands

Hint:

Sjogren syndrome = dry eyes, dry mouth, anti-Ro/SSA, anti-La/SSB, and lymphocytic destruction of exocrine glands.

Answer 1

The Correct Option is C

Step 1: Understanding the Question:
The combination of "sicca" symptoms (dry eyes, dry mouth) and positive anti-Ro/La antibodies is diagnostic of Sjögren’s Syndrome.
Step 2: Detailed Explanation:

Sjögren’s Syndrome: This is a chronic autoimmune disease primarily affecting the exocrine glands.

Pathology: The fundamental mechanism is a lymphocytic infiltration (specifically CD4+ T-cells and B-cells) of the lacrimal and salivary glands.

Histology: A lip biopsy (minor salivary gland) is often used for confirmation, showing "focal lymphocytic sialadenitis." The severity is measured by the "Focus Score."

Serology: Anti-Ro (SSA) and Anti-La (SSB) antibodies are the characteristic serological markers.

Complications: The dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia) lead to corneal ulcers and dental caries. Importantly, these patients have a 40-fold increased risk of developing B-cell MALT lymphoma.

Step 3: Final Answer:
The destruction of moisture-producing glands in Sjögren’s syndrome is mediated by chronic lymphocytic infiltration.