Acute iritis associated with primary Sjögren's 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 Sjögren'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 Sjögren's syndrome is acute uveitis. Combination immunosuppressive therapy may be needed to control this condition.