1. Sjogren’s Syndrome and Hyper Lipoprotienemia(a)
A Detrimental Association
- Dr. Uday Shanker Sagaram
Director, Maruthi Rheumatology Research Centre, Hyderabad, India

2. Sjogren’s Syndrome and Hyper lipoproteinemia(a) - Detrimental Association
What is Lp(a)
Lipoproteins are the spherical particles composed of Proteins (Apolipoproteins), Phospholipids, Triglycerides and Cholesterol
They are manufactured in the liver and are associated with LDL fraction of lipid profile, which is highly risky and detrimental
They penetrate and are strongly retained to the arterial wall
They possess pro-inflammatory activity
Lp(a) is a strong risk factor for CVD. The lack of clinical trial data has resulted in Lp(a) being largely ignored by clinical guidelines

3. What is Sjogren’s Syndrome?
Sjogren’s Syndrome and Hyper lipoproteinemia(a) - Detrimental Association
What is Sjogren’s Syndrome?
“Chronic auto-immune disorder where, WBC attack salivary and lacrimal glands”
Causes
Hereditary
Viral/ bacterial infections
Diagnosis
Xero stomia
Kerato conjunctivis sicca
Submandibular gland enlargement
Hoarseness of voice
Dysphagia, etc.

4. What is Sjogren’s Syndrome? … contd…
Sjogren’s Syndrome and Hyper lipoproteinemia(a) - Detrimental Association
What is Sjogren’s Syndrome? … contd…
Tests
Anti SSA and Anti SSB
Ophthalmologist tests - Rose Bengal test and Schirmer test
Immunological test
Complication(s)
44% times more risk of having Non-Hodgkins Lymphoma
Pregnant women deliver Neonatal Lupus child with heart block
Hepatitis
Bronchitis
Dyspareunia
Corneal ulcer

5. When and Why did I start checking for Lp(a)
Sjogren’s Syndrome and Hyper lipoproteinemia(a) - Detrimental Association
When and Why did I start checking for Lp(a)
In some of the Inflammatory Arthritis patients, we noticed persistently (3-6 months) elevated Lipid Profile in their routine blood examinations
Research and discussion with other physicians lead to the identification of Lp(a) as the root cause
We then discovered associated increase in Lp(a) levels and also noticed associated drowsiness and cardiac pain

6. Why this association is to be given importance?
Sjogren’s Syndrome and Hyper lipoproteinemia(a) - Detrimental Association
Why this association is to be given importance?
This association is detrimental, as it produces coronary premature Atherosclerosis and also Cerebral Vascular Stroke
Since Sjogren’s syndrome alone generally has a long life span, only its association with Lp(a) can reduce it

7. Sjogren’s Syndrome and Hyper lipoproteinemia(a) - Detrimental Association
Effects
Coronary Artery Calcification - In diabetic and rheumatoid arthiritis patients
Dyslipedemia with low cholesterol level, low HDL level and high triglyserides
Associated hypo-thyroidism
Irritable Bowel Disorder (IBD)
Mixed Connective Tissue Disorders (MCTD)
Scleroderma
Psoriatic Arthritis

8. Sjogren’s Syndrome and Hyper lipoproteinemia(a) - Detrimental Association
Treatment for Lp(a)
Treatment of Sjogren’s Syndrome (hydroxyl chloroquine and deflaza cort) combined treatment of Lp(a) (1gm Niacin, 1000mg Omega Fatty-acids and aspirin)
Correction of hypothyroidism, any associated diabetes and Nephropathy
Treatment of associated dyslipidemia
Vitamin C administration
Bovine collustrum

9. Sjogren’s Syndrome and Hyper lipoproteinemia(a) - Detrimental Association?

10. About the Presenter Dr. S. Uday Shanker
Director of Maruthi Rheumatology Research Center, Secunderabad, India.
Recent Awards
Life Time Achievement Award in Medicine with Gold Medal
Bharatiya Chikitsak Award
Hind Ratan International Award and more
Published several papers in Cardiology and Rheumatology.
Contact Information
Cell: +1(850) (USA)
Cell: +(91) (India)