Sjögren's syndrome (SS) is a chronic autoimmune disorder characterized by lymphocytic infiltration of exocrine glands, resulting in xerostomia and keratoconjunctivitis sicca. Beyond glandular involvement, systemic manifestations, particularly pulmonary complications, significantly contribute to morbidity and mortality in affected individuals. Pulmonary complications in SS range broadly, encompassing interstitial lung conditions, airway inflammation, nodular formations, cystic abnormalities, and pulmonary hypertension. Diagnosis relies on high-resolution computed tomography, pulmonary function tests (PFTs), and, in selected cases, histopathologic evaluation. We describe the cases of two patients with primary SS presenting with distinct pulmonary findings: one with an incidental pulmonary nodule and the other with organizing pneumonia on a background of cellular non-specific interstitial pneumonia. These presentations illustrate the clinical heterogeneity and diagnostic complexity of pulmonary involvement in SS. These cases highlight the importance of recognizing SS-related pulmonary complications, which may present subtly and require multidisciplinary evaluation. Increased awareness among healthcare providers and early diagnostic workup are essential to improve patient outcomes.

Sjögren's syndrome (SS) is a chronic autoimmune disorder primarily affecting exocrine glands, characterized by dry mouth (xerostomia) and dry eyes (keratoconjunctivitis sicca). However, systemic manifestations, including pulmonary complications, are increasingly recognized. Diffuse alveolar hemorrhage (DAH) is a rare but life-threatening presentation of SS, typically associated with vasculitis or coagulation abnormalities. We report the case of a 19-year-old male presenting with dyspnea and hemoptysis, later diagnosed with primary Sjögren's syndrome (pSS). Initial clinical assessment revealed respiratory failure with low blood oxygen levels (hypoxemia), bilateral ground-glass opacities on chest computed tomography (CT), and iron-storing macrophages (hemosiderin-laden) in bronchoalveolar lavage fluid, consistent with DAH. Subsequent autoimmune serology confirmed positivity for anti-Ro/Sjögren's-syndrome-related antigen A autoantibodies (SSA) and anti-La/Sjögren's-syndrome-related antigen B autoantibodies (SSB), while other autoimmune markers, including anti-neutrophil cytoplasmic antibodies (ANCA), were negative. Labial salivary gland biopsy demonstrated focal lymphocytic sialadenitis, confirming pSS according to European League Against Rheumatism (EULAR) criteria. Treatment involved high-dose corticosteroids, leading to complete resolution of symptoms and significant improvement in imaging results. The patient remained stable at follow-up. DAH should be considered a potential presentation of pSS, even in the absence of classical symptoms. Increased awareness of this rare complication can facilitate early diagnosis and improve outcomes.

Primary Sjögren's syndrome (pSS) is an autoimmune disorder characterized by xerostomia and keratoconjunctivitis sicca, with approximately 10%-20% of patients developing concurrent immune thrombocytopenia (ITP). Recent studies suggest the pathogenesis of primary Sjögren's syndrome - associated immune thrombocytopenia (pSS-ITP) may involve dysregulated TLR7 signaling, B-cell hyperactivation, and autoantibody-mediated platelet destruction. Beyond conventional therapies (e.g., glucocorticoids and intravenous immunoglobulin [IVIG]), emerging treatments have garnered increasing attention, including thrombopoietin receptor agonists (TPO-RAs), B-cell-targeted therapies, and mTOR inhibitors. Predictive models incorporating bone marrow megakaryocyte counts and autoantibody profiles may facilitate individualized treatment selection. Future multicenter clinical studies are warranted to evaluate the long-term efficacy and safety of novel agents and to explore biomarker-guided precision therapy. This review systematically summarizes the pathophysiological mechanisms of pSS- ITP, synthesizes current clinical treatment strategies, and highlights key biomarkers with potential implications for therapeutic response, aiming to provide a theoretical foundation and practical guidance for optimizing individualized therapeutic regimens.

Canine visceral leishmaniasis (CVL), caused by Leishmania infantum, is a multisystemic disease in which ocular involvement is frequent but often underestimated. This study aimed to comprehensively evaluate the clinical, ophthalmological, parasitological, hematological, biochemical, and histopathological alterations in dogs naturally infected with L. infantum from an endemic area of northeastern Brazil, with special emphasis on the relationship between ocular manifestations and systemic disease. Twenty-five symptomatic dogs were evaluated through clinical and ophthalmological examinations, parasitological culture, PCR, laboratory analyses, and histopathology of ocular and periocular tissues. Ocular alterations were observed in 80% of the animals, predominantly bilateral and frequently associated with multiple concurrent lesions, including ocular discharge, conjunctivitis, blepharitis, uveitis, and corneal opacity. Functional ophthalmological tests revealed keratoconjunctivitis sicca and corneal ulcers in a substantial proportion of dogs. Hematological abnormalities were highly prevalent, particularly anemia and thrombocytopenia. Comparative analysis demonstrated that dogs with ocular involvement exhibited significantly higher leukocyte counts and segmented neutrophils, as well as increased AST levels, indicating an enhanced systemic inflammatory response. Histopathological examination revealed intense plasmacytic inflammatory infiltrates and the presence of amastigote forms in ocular and periocular tissues, indicating that both immune-mediated and parasite-driven mechanisms could be involved in disease pathogenesis. Collectively, these findings underscore ocular involvement as a clinically relevant manifestation of CVL and reinforce the importance of routine ophthalmological evaluation in clinical management.

Sjogren's syndrome (SS) is a chronic autoimmune disorder characterised by lymphocytic infiltration of exocrine glands, leading to xerostomia and keratoconjunctivitis sicca. To analyse the demographic details, clinical presentations, and serological and histopathological findings in a series of patients diagnosed with SS. This retrospective case series of SS was conducted at a tertiary institution in Kerala. The study comprised 10 patients with a mean age of 49 years, exhibiting a female-to-male ratio of 9:1. The most common clinical signs included xerostomia (90%), xerophthalmia (100%). Histopathological examination revealed focal lymphocytic sialadenitis in all cases (100%), with a mean focus score of 1.35. SS predominantly affects middle-aged women and presents with sicca symptoms. Histopathological examination of labial salivary glands remains the valuable diagnostic tool. Future research should concentrate on exploring targeted therapies that can improve the quality of life for those affected by SS.

A young female French bulldog with a history of chronic right keratoconjunctivitis sicca (KCS) because since birth was referred for an acute onset of nonambulatory tetraparesis. Right trigeminal nerve sensory deficits, including right corneal anesthesia and absent facial sensation, were identified during examination. Magnetic resonance imaging (MRI) of the neurocranium was performed, revealing severe hypoplasia to the absence of the right trigeminal ganglion, consistent with reports of congenital trigeminal hypoplasia/aplasia in human medicine. This represents a very rare but important differential in young patients with a history of non-responsive KCS, recurrent or slow healing corneal ulceration, and absent corneal sensation.