Preoperative abnormalities

1. Symptoms of the sicca syndrome include dryness of the eyes, mouth, vagina, and skin.

2. Conditions associated with the secondary form include rheumatoid arthritis, systemic lupus, scleroderma, the polymyositis/ dermatomyositis complex, polyarteritis nodosa, chronic active hepatitis, and Grave's disease.

3. Swelling of the salivary and lacrimal glands may be prominent.

4. Lung complications are being detected more often, because of the greater sensitivity of tests of pulmonary disease (Cain et al 1998). Dessication of the nose and bronchial tree, obstructive airways disease particularly affecting the small airways (Papiris et al 1999), and interstitial lung disease, are the most common (Gardiner 1993). Lymphomas may develop.

5. Kidney, liver, pancreas and lymphoid tissue are other major organs at risk.

6. Either a sensory or motor neuropathy may occur and CNS lesions have been described.

7. The patient may be taking corticosteroids or occasionally immunosuppressive agents.

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