What is Sjogren's syndrome?
Sjogren's syndrome features a combination of dry eyes, dry mouth, and another diseases of the connective tissues, most commonly rheumatoid arthritis.
Sjogren's syndrome is an autoimmune disease, characterized by the abnormal production of antibodies in the blood that are directed against various tissues of the body. This particular autoimmune illness is caused by inflammation in the glands of the body. Inflammation of the lacrimal glands leads to decreased water production for tears and eye dryness. Inflammation of salivary glands leads to mouth dryness.
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.
Cause of Sjogren's syndrome:
While the exact cause of Sjogren's syndrome is not known, there is growing scientific support for genetic (inherited) factors. The illness is sometimes found in other family members. It is also found more commonly in families that have members with other autoimmune illnesses, such as systemic lupus erythematosus, autoimmune thyroid disease, juvenile diabetes, etc. 90% of Sjogren's syndrome patients are female.
Symptoms of Sjogren's syndrome:
Symptoms of Sjogren's syndrome can involve the glands, as above, but there are also possible affects of the illness involving other organs of the body (extraglandular manifestations).
When the tear gland (lacrimal gland) is inflamed from Sjogren's, the resulting eye dryness can progressively lead to eye irritation, decreased tear production, "gritty" sensation, infection, and serious abrasion of the dome of the eye (cornea).
Inflammation of the salivary glands can lead to mouth dryness, swallowing difficulties, dental decay, gum disease, mouth sores and swelling, stones and/or infection of parotid gland inside of the cheeks.
Other glands that can become inflamed, though less commonly, in Sjogren's syndrome include those of the lining of the breathing passages (leading to lung infections) and vagina (sometimes noted as pain during intercourse).
Extraglandular (outside of the glands) problems in Sjogren's syndrome include joint pain or inflammation (arthritis), Raynaud's phenomenon, lung inflammation, lymph node enlargement, kidney, nerve, and muscle disease. A rare serious complication of Sjogren's syndrome is inflammation of the blood vessels (vasculitis), which can damage the tissues of the body that are supplied by these vessels.
A common disease that is occasionally associated with Sjogren's syndrome is autoimmune thyroiditis (Hashimoto's thyroiditis), which can lead to abnormal hormone levels detected by thyroid blood tests. Heartburn and difficulty swallowing can result from gastroesophageal reflux disease (GERD), another common condition associated with Sjogren's syndrome. A rare disease that is uncommonly associated with Sjogren's syndrome is primary biliary cirrhosis, an immune disease of the liver that leads to scarring of the liver tissue. A small percentage of patients with Sjogren's syndrome develop cancer of the lymph glands (lymphoma). This usually develops after many years with the illness. Unusual gland swelling should be reported to the physician.
Sjogren's syndrome - How Is It Diagnosed?
• Medical exam
• Lab tests
• Chest X-rays
• Lip biopsy
• Schirmer test/slit-lamp exam (measures dryness of eyes)
• Urine test (for kidney function)
Sjogren's syndrome Treatment Conventional Therapy:
The treatment of patients with Sjogren's syndrome is directed toward the particular areas of the body that are involved and complications, such as infection. There is no cure for Sjogren's syndrome.
Dryness of the eyes can be helped by artificial tears, eye lubricant ointments at night, and minimizing the use of hair dryers.
The dry mouth can be helped by drinking plenty of fluids, humidifying air, and good dental care to avoid dental decay. The glands can be stimulated to produce saliva by sucking on sugarless lemon drops or glycerin swabs. Additional treatment for the symptom of dry mouth are prescription medications that are saliva stimulants, such as pilocarpine (Salagen) and cevimeline (Evoxac). Vitamin E oil has been used with some success.
Salt water (saline) nasal sprays can help dryness in the passages of the nose. Vaginal lubricant should be considered for sexual intercourse.