To describe a nonsurgical treatment for superficial corneal epithelial inclusion cysts (CEICs) in dogs and to characterize their clinical and diagnostic features using ultrasound biomicroscopy (UBM) and optical coherence tomography (OCT).

Interstitial Cystitis, mostly affecting middle-aged women, has been rarely associated with Sjögren's syndrome. We report a 51-year-old woman who presented with painful micturition, pollakiuria, lower abdominal pain, and urinary urgency. In addition, the patient exhibited xerostomia, keratoconjunctivitis sicca, and leukopenia. The cystoscopy and pathological examinations confirmed the diagnosis of interstitial cystitis. Subsequent testing revealed a positive antinuclear antibody, leading to referral to the department of Rheumatology and Immunology for a labial gland biopsy, which resulted in a diagnosis of primary Sjogren's Syndrome. This case highlights the association between Sjögren's syndrome and interstitial cystitis, emphasizing the need for clinicians to maintain a suspicion for systemic autoimmune disorder when encountering patients with recurrent urinary tract symptoms without any other identifiable underlying cause.

Rheumatoid arthritis (RA) is a systemic autoimmune disease that can involve the ocular surface and deeper ocular tissues, leading to a spectrum of ophthalmic manifestations ranging from dry eye disease to vision-threatening inflammation, such as scleritis and peripheral ulcerative keratitis (PUK). This paper presents the results of a narrative review conducted using PubMed and Google Scholar from database inception to March 2026. Eligible publications describing clinical features and management of RA-associated ocular disease were synthesized, and no unpublished data were included. According to the literature, dry eye disease (DED) is the most frequent ocular manifestation of RA, and it is primarily managed with lubrication and topical anti-inflammatory therapies, including cyclosporine and lifitegrast. Additional options for refractory disease include neurostimulation and evaporation-targeted therapy. Scleritis and PUK are less common but represent severe inflammatory complications that generally require systemic immunosuppression. Conventional management includes systemic corticosteroids and steroid-sparing agents such as methotrexate (MTX), azathioprine (AZA), cyclophosphamide (CYC), and mycophenolate mofetil (MMF) in aggressive cases. Escalation to biologic disease-modifying antirheumatic drugs (bDMARDs), specifically tumor necrosis factor-alpha (TNF-α) inhibitors and rituximab (RTX), is supported for refractory scleritis and corneal melt, although evidence is largely observational. Among anti-TNF agents, monoclonal antibodies, such as infliximab and adalimumab, appear more effective than etanercept for ocular inflammation. Rituximab is preferred for vasculitis-associated or refractory disease, and Janus Kinase (JAK) inhibitors represent an emerging option requiring careful safety monitoring. Evidence for DED therapies includes randomized controlled trials (RCTs), whereas data for RA-associated scleritis and PUK are largely derived from registries, case series, and case reports. Prospective studies with standardized ocular outcomes are needed to refine treatment algorithms and compare the effectiveness of biologic versus targeted synthetic agents.

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.

Potentiated sulphonamides (TMS) are recommended first-line antimicrobials in veterinary medicine, yet their use may be limited by concerns about adverse events (AEs). This systematic review aimed to evaluate the frequency, nature, and potential risk factors for TMS-associated AEs in dogs and cats. Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) reporting standards, 110 studies published between 1943 and 2024 were included, covering > 4200 treated animals. A pairwise meta-analysis of eight comparative studies did not suggest a clinically relevant increased risk of AEs with TMS compared to other antimicrobials in either cats or dogs. A proportional meta-analysis of 31 studies in dogs showed an estimated prevalence of mild (2.3%) and severe (0.2%) AE. AE were described in more detail in 80 studies. The most commonly described severe AE were keratoconjunctivitis sicca, immune-mediated polyarthritis, hepatic necrosis, and haematological disorders. Severe AEs were reported in 64 studies and 247 animals, while mild AEs were reported in 23 studies. The most frequently implicated combinations were sulfadiazine- or sulfamethoxazole-trimethoprim. Time to onset ranged from hours to weeks and appeared longer for severe reactions. AEs were more frequently reported after treatment durations exceeding seven days. In breed-specific analyses, Doberman Pinschers were overrepresented among cases with polyarthritis. These findings suggest that while TMS can cause serious AEs, the incidence is low, and judicious use may reduce reliance on critically important antibiotics.

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.