Skip to content
Search
Search
Home
About Us
About APLAR
APLAR Milestones
President Message
Committees
APLAR Directors
Executive Committee
Other Committees
Membership
Member National Organizations
Constitution & Terms of Reference
Membership Application
Membership Update
Academy
APLAR Academy
Governance
Membership
Short Course
Upcoming Course
Past Course
Academy Webinar
Upcoming Webinar
Past Webinar
Grand Round
Upcoming Grand Round
Past Grand Round
Discussion Forum
Grand Round Blackboard
ASPIRE Grant
About APLAR ASPIRE
ASPIRE Core Training Modules
ASPIRE Implementation Toolkit
About SIG
AYR
ABOUT AYR
AYR Board
Committee
AYR Membership
AYR Webinar
Upcoming Webinar
Past Webinar
AYR Blackboard
Discussion Forum
Collaboration
APLAR ESOR
ESOR Application
Post Event Submission
Online Submission
EULAR School of Rheumatology
Exchange Programme
Exchange Programe Application
Online Submission
EULAR Exchange Program
APLAR MNO Patronage
Patronage Application
Online Submission
EULAR Collaborations
Center Of Excellence
APLAR CoEs
New Application
Renew CoE Application
Online Submission
Grants and Awards
Grant
COPCORD Grant
Congress Travel Grant
Research Grant
Fellowship Grant
Award
Master Award
Events
Congress
Upcoming Congress
Past Congress
Events
Upcoming Events
Past Events
Gallery
Publications
Published Journal
SIG Publication
COVID – 19 Publication
IJRD
Voice Of APLAR
Patient Education
APLAR Sjögren’s Syndrome Registry – Form 5
"
*
" indicates required fields
Comorbidities and associated autoimmunity
Centre
*
Serial No
*
Consent Signed
*
Yes
No
Date of Recruitment
*
DD slash MM slash YYYY
Age at Recruitment
*
Name
*
First
Last
Female
*
Male
Female
Prefer not to respond
Hospital ID
*
Comorbidities
Comorbidities
HTN
DM
Hypothyroid
Hyperthyroid
Dyslipidemi
CVD
CAD
Asthma
Malignancy
Others
Select All
Please Specify Others:
Diseases
APLA
Neuromyelitis Optica Spectrum D 10
Multiple sclerosis
Autoimmune Thyroid disease
Celiac Disease
Others
APLA Clinical and Lab Features
Neuromyelitis Optica Spectrum D Clinical and Lab Features
Multiple sclerosis Clinical and Lab Features
Autoimmune Thyroid disease Clinical and Lab Features
Celiac Disease Clinical and Lab Features
Others Clinical and Lab Features
Family History
SS
SLE
RA
Scleroderma
Myositis
Hypothyroid
Hyperthyroid
Others
Relative(s) affected by SS
Relative(s) affected by SLE
Relative(s) affected by RA
Relative(s) affected by Scleroderma
Relative(s) affected by Myositis
Relative(s) affected by Hypothyroid
Relative(s) affected by Hyperthyroid
Relative(s) affected by Others (Please specify the disease(s))