Acute iritis associated with primary Sjögren's syndrome and high-titer anti-SS-A/Ro and anti-SS-B/La antibodies. Treatment with combination immunosuppressive therapy.
OBJECTIVE
We describe a patient with primary Sjögren's syndrome who developed severe, acute, anterior uveitis (iritis), an uncommon complication in this setting.


METHODS
We present the case report of the clinical findings, course, treatment, and resolution of the acute uveitis. Titers of anti-SS-A/Ro and anti-SS-B/La antibodies were assessed (by immunodiffusion), as were fluorescent antinuclear antibodies (on HEp-2 cells) and cryoglobulins.


RESULTS
Initial treatment with topical steroids, oral prednisone (20 mg/day), and oral methotrexate was unsuccessful. The iritis resolved after combined treatment with intravenous cyclophosphamide (1,500 mg/month), high-dose prednisone (60 mg/day), and cyclosporine (5 mg/kg/day).


CONCLUSIONS
An uncommon, severe complication of primary Sjögren's syndrome is acute uveitis. Combination immunosuppressive therapy may be needed to control this condition.
Bridges
A J
AJ
Department of Internal Medicine and Pathology, University of Missouri-Columbia School of Medicine.
Burns
R P
RP
D000974:Antibodies, Antinuclear / Q000032:analysis*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007500:Iritis / Q000150:complications* / Q000276:immunology* / Q000628:therapy; D008875:Middle Aged; D012859:Sjogren's Syndrome / Q000150:complications* / Q000276:immunology* / Q000628:therapy
D000974:Antibodies, Antinuclear; D007166:Immunosuppressive Agents; C035356:SS-A antibodies; C035357:SS-B antibodies