Sjogren’s syndrome is a common autoimmune disorder that attacks moisture-producing glands of the body, such as the glands that produce tears and saliva. In an autoimmune disorder, the body’s immune system mistakenly attacks healthy tissues. In Sjogren’s syndrome, inflammation caused by this attack affects the glands’ ability to secrete moisture and mucus normally.
Sjogren’s syndrome can affect the glands in the eyes, mouth, throat, nose, airways, skin, digestive system, and vagina. In some cases, Sjogren’s syndrome can attack areas throughout the body, such as the lungs, kidneys, joints, blood vessels, and nervous system.
Symptoms of Sjogren’s syndrome are due to abnormal dryness of the affected glands and organs. Typical symptoms of Sjogren’s syndrome include dry eye, dry cough, dry mouth, and poor oral and dental health.
There are two types of Sjogren’s syndrome, primary and secondary. Primary Sjogren’s syndrome occurs in the absence of other autoimmune disorders. Secondary Sjogren’s syndrome occurs with other autoimmune disorders, such as lupus and rheumatoid arthritis, and is generally more serious than primary Sjogren’s syndrome. Secondary Sjogren’s syndrome is more likely than primary Sjogren’s syndrome to lead to complications.
Sjogren’s syndrome cannot be cured, but it can be treated to minimize symptoms and reduce the risk of complications. Treatment can include a combination of medication, good oral hygiene, and possibly surgery.
Serious complications, such as liver disease and lung disease, can occur with Sjogren’s syndrome, especially secondary Sjogren’s syndrome.
Seek prompt medical care if you have symptoms of Sjogren’s syndrome, such as dry mouth and dry cough. Early diagnosis and treatment can help reduce the risk of complications.
If you can't dare eat a cracker without a glass of water handy, the chances are, you may have Sjogren's syndrome. This is an autoimmune illness that was first called "keratoconjunctivitis sicca" by Swedish opthamologist Henrik Sjogren during the early 1900's. The word used to describe dryness of your eyes along with the mouth is "sicca".
This disorder affects the exocrine glands; or glands which are moisture- producing.
Females have the disease more frequently than men. Ninety percent of Sjogren's patients are female. Identifying this disease might take years.
Diagnosis should include several tests: Eye tests, lip biopsies, and blood tests. Biopsies are taken from the inner lip and from the salivary glands. Tear testing is measured by a Shirmer test.
So far, there is no known cure for Sjogren's. There is treatment for the many symptoms. To relieve the feeling of dryness in the mouth, lozenges, mouthwashes, and special toothpastes, can assist. Eye drops for dry eyes. Some patients have their tear ducts plugged simply to keep remaining moisture in the eyes.
Doctors recommend regular dental check-ups to maintain overall dental health. Your doctor may refer you to a rheumatologist when the disease is suspected. Sjogren's Disease also affects the central nervous system. Most patients can lead normal lives however.
Sjogren's syndrome is a disorder of the immune system and it is often characterized by its two most common symptoms — dry eyes and a dry mouth.
Most people have never heard about Sjogren's but is it important to know that it's a disease that often accompanies other autoimmune disorders — rheumatoid arthritis, lupus and other which are marked by inflammation of connective tissues. Every patient should know that, in Sjogren's syndrome, immune system attacks healthy tissue-in this case- the mucous membranes and moisture-secreting glands of eyes and mouth. All this is resulting in decreased production of tears and saliva and can lead to problems from difficulty swallowing to dental cavities to light-sensitive eyes to corneal ulcers. Sjogren's syndrome can also result in damage to tissues of lungs, kidneys and liver. Sjogren's syndrome that involves the gland inflammation (resulting in dryness of the eyes and mouth, etc.), but not associated with a connective tissue disease, is referred to as primary Sjogren's syndrome. Secondary Sjogren's syndrome involves not only gland inflammation, but is associated with a connective tissue disease, such as rheumatoid arthritis, systemic lupus erythematosus, or scleroderma. Unfortunately- there's no cure for Sjogren's syndrome, but treatments can relieve many of the symptoms.
Incidence of the condition
Sjogren's syndrome affects 1-4 million people in the United States. Although you can develop Sjogren's syndrome at any age, most people are older than forty at diagnosis. The condition is nine times as likely to occur in women as in men and the disease affects predominantly middle-aged women, in the peri- or post-menopausal period. However, it can be seen in both sexes and all ages. Although many people still haven’t heard about this condition- it is considered to be quite common since in addition to the primary syndrome, thirty percent of patients with rheumatoid arthritis, systemic lupus erythematosus and systemic sclerosis suffer secondary Sjögren’s syndrome. It is also proven that two to five percent of people aged sixty and above have primary Sjögren’s syndrome.
Signs and symptoms of Sjogren’s syndrome
Bad thing with describing the characteristic symptoms of Sjogren's syndrome as well with diagnosis- is the fact that the signs and symptoms are similar to those caused by other diseases and can vary from person to person. Not only that but-the side effects of a number of medications can mimic some signs and symptoms of Sjogren's syndrome. Typical signs and symptoms of Sjogren's include:
• Difficulty swallowing or chewing
• Change in sense of taste
• Dry eyes
• Dry mouth
• Dental cavities
• Oral yeast infections, such as candidiasis
• Dry cough that doesn't produce sputum
• Joint pain, swelling and stiffness
• Irritation and mild bleeding in your nose
• Enlarged parotid glands
• Skin rashes or dry skin
• Vaginal dryness
Possible causes of Sjogren’s syndrome
Every patient should know that Sjogren's syndrome is an autoimmune disorder which means that the body attacks its own cells and tissues. Unfortunately- it's unknown why this happens, but researchers believe that a combination of factors trigger something to go wrong with the immune system. These triggers could be:
• viral or bacterial infection
• nervous system disorder
In the case of Sjogren's syndrome, white blood cells called lymphocytes target, attack and damage your moisture-producing glands. These cells can also damage other organs, including lungs, kidneys and liver.
Risk factors for developing Sjogren’s syndrome
Unfortunately- although anyone can develop Sjogren's syndrome, it typically occurs in people with one or more known risk factors. These include:
• Rheumatic disease
It's common for people who have Sjogren's syndrome to also have a rheumatic disease, such as rheumatoid arthritis, lupus, scleroderma or poliomyelitis. It is proven that this places you at high risk for developing this syndrome!
• Being female
It is already mentioned that women are nine times as likely as men to have Sjogren's syndrome.
• Being a certain age
Sjogren's syndrome is usually diagnosed in people older than forty.
• Having a family history of Sjogren's
Sjogren's syndrome sometimes runs in families although some specific gene which is responsible for the condition still has not been found!
Diagnosis of Sjogren’s syndrome
• Patient’s history
To diagnose Sjogren's syndrome, every doctor should first ask for a history of symptoms, including how long the patient has them. Doctor may ask about diet, including the types and quantities of liquids that a patient drinks in a day.
• Blood tests
Every patient should know that doctor may order blood tests to check blood counts and sedimentation rate. The main purpose of these tests is of course- to check for autoantibodies. Sometimes antibodies do not show up in the blood tests and may not show themselves until the disease is more progressed. Checking blood count allows the doctor to know the proportion of the various types of blood cells in a given volume of your blood. Autoantibodies can play a role in the inflammatory response, which can damage tissues and organs.
• Tear test
Because the condition affects ability to produce tears- doctor can measure the dryness of patient’s eyes with one test called- the Schirmer tear test, in which a small piece of filter paper is placed under lower eyelid to measure tears. An ophthalmologist may also examine eyes with a slit-lamp after placing a drop of liquid containing a dye in eye.
Not too many people have heard about this test, but it is important to know that, to check on the condition of salivary glands, doctors often order a special X-ray called a sialogram. It detects dye that is injected into parotid glands, located behind jaw and in front of ears. What's good about this test- it reveals the flow of saliva into mouth. The doctor may perform a parotid gland flow test to determine the amount of saliva that a patient produces over time.
Your doctor may also recommend a lip biopsy to detect the presence of clusters of inflammatory cells, which can indicate Sjogren's syndrome. Test- a small sliver of tissue is removed from the salivary glands located in your lip.
• Urine sample
Urine sample that can be analyzed in the laboratory to determine whether Sjogren's syndrome has affected kidneys.
Possible complications if left untreated
Although there are many possible complications of Sjogren's syndrome – most of them are more annoying than serious. Common complications of Sjogren's syndrome include:
• Difficulty swallowing
• Dental cavities
• Vision problems
Less common complications include:
• Inflammation of organs such as lungs, kidneys or liver
These inflammations can cause pneumonia, bronchitis or other problems in lungs and may lead to problems with kidney function.
• Heart problems for babies born to mothers with Sjogren's syndrome
When a patient is planning to become pregnant, she should talk with doctor about being tested for certain autoantibodies that may be present in blood because they have been associated with a neonatal lupus syndrome.
• Cancer of the lymph nodes (lymphoma)
• Peripheral nervous system disorders
Most common symptoms are numbness, tingling and burning.
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
This group of medications help relieve both pain and inflammation. The most commonly used is Aspirin! Always taken with food.
Most people already know that these medications reduce inflammation and may slow joint damage. In the short term, corticosteroids can make you feel dramatically better. Possible side effects may include easy bruising, thinning of bones, cataracts, weight gain, a round face, diabetes and high blood pressure.
• Hydroxychloroquine (Plaquenil)
This antimalarial drug may be useful if you have inflamed joints.
• Pilocarpine (Salagen)
Pilocarpine should be prescribed if the patient has dry-mouth
It works by causing certain mouth glands to produce more saliva. Common side effects may include excessive sweating, nausea, and a runny or stuffy nose.
These medications, such as Cyclophosphamide (Cytoxan), methotrexate (Rheumatrex), mycophenolate (CellCept) and Azathioprine (Imuran), suppress the immune system.
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To relieve the dry eye symptom, a minor surgical procedure can be done. Collagen or silicone plugs are inserted into the tear ducts.
Unfortunately- Sjögren’s syndrome remains fundamentally an incurable disease, since no therapeutic method has been identified that may alter the course of the disease. However, the treatment of dry eyes is largely symptomatic and includes artificial tears and lubricant ointments. Occasionally, patients may require surgical punctual occlusions to block tear drainage.
The cause of Sjogren’s syndrome is not known, but it is believed that this autoimmune disorder may be triggered by a viral infection or a bacterial infection. Genetic factors may also play a role in Sjogren’s syndrome. Research indicates that the presence of certain genes may make you more susceptible to the abnormal immune process when confronted with an environmental trigger, such as a viral or bacterial infection.
The possibility that the endocrine and nervous systems play a role is also under investigation.
What are the possible complications of Sjogren’s syndrome?
Secondary Sjogren’s syndrome is more likely than primary Sjogren’s syndrome to lead to the most serious complications. Complications of either type of Sjogren’s syndrome include:
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Cancer, glaucoma, positive status for human immunodeficiency virus, acquired immune deficiency syndrome, hepatitis C, amyotrophic lateral sclerosis, Crohn’s disease, agitation of Alzheimer’s disease, cachexia/wasting syndrome, muscular dystrophy, severe fibromyalgia, spinal cord disease, including but not limited to arachnoiditis, Tarlov cysts, hydromyelia, syringomyelia, rheumatoid arthritis, fibrous dysplasia, spinal cord injury, traumatic brain injury and post-concussion syndrome, multiple sclerosis, Arnold-Chiari malformation and syringomyelia, s pinocerebellar ataxia (SCA), Parkinson’s, Tourette’s, myoclonus dystonia, reflex smpathetic dystrophy( RSD), complex regional pain syndromes type I, causalgia, CRPS (Complex regional pain syndromes type II), n eurofibromatosis, chronic inflammatory demyelinating polyneuropathy, Sjogren’s syndrome, lupus, interstitial cystitis, myasthenia gravis, hydrocephalus, nail-patella syndrome, residual limb pain, or the treatment of these conditions.
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