ACUTE IRITIS ASSOCIATED WITH PRIMARY SJOGRENS-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 Sjogren'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). Conclusion. An uncommon, severe complication of primary Sjogren's syndrome is acute uveitis. Combination immunosuppressive therapy may be needed to control this condition.