Rosh Internal Medicine Boost Practice Exam

What is the most common autoimmune condition associated with dry eyes and mouth?

1. Rheumatoid arthritis

2. Sjögren syndrome

3. Systemic lupus erythematosus

4. Hashimoto's thyroiditis

The correct answer is: Sjögren syndrome

The association of dry eyes and mouth as hallmark symptoms is most characteristically seen in Sjögren syndrome. This autoimmune condition primarily targets the exocrine glands, leading to the destruction of the glands responsible for moisture production, such as the salivary glands and lacrimal glands. In Sjögren syndrome, the inflammation results in diminished saliva secretion, causing dry mouth (xerostomia), while decreased tear production leads to dry eyes (keratoconjunctivitis sicca). The diagnosis of Sjögren syndrome can be confirmed through specific labial salivary gland biopsy or through serologic markers like anti-SS-A (Ro) and anti-SS-B (La) antibodies, which are prevalent in this condition. While other autoimmune diseases like rheumatoid arthritis, systemic lupus erythematosus, and Hashimoto's thyroiditis can feature some level of dry mouth or eyes as secondary effects or complications, they do not have the same primary impact on exocrine gland function or a prominent clinical association with these symptoms. Therefore, Sjögren syndrome stands out as the most common autoimmune condition specifically linked to both dry eyes and dry mouth.