Sjogren’s syndrome

  • Sjogren’s syndrome is an autoimmune disease characterized by dry eyes and dry mouth.
  • There is inflammation in the parotid gland (which secrete saliva) and lacrimal gland (which secrete tear) and decrease their function resulting in saliva and tear production.
  • Usually this is seen in middle aged women (after 35 years of age). It occurs in females 9 time higher than males
  • Complications in other parts of the body can occur. Pain and stiffness in the joints, Rashes on the arms and legs related to blood vessels inflammation (vasculitis) etc are very common. Besides inflammation in the lungs, liver, and kidney may occur rarely and be difficult to diagnose.
  • The parotid gland (at the edge of the jaw) may become swollen and inflamed in some people with Sjögren’s Syndrome.
  • Sjögren’s syndrome is an autoimmune condition most common in middle age to older women.
  • It can present itself (Primary Sjogren syndrome) or as a complication of another autoimmune disease, such as rheumatoid arthritis or lupus (Secondary Sjogren syndrome)
  • Most common symptom is dryness of mouth and eye due to decrease in saliva and tear production.
  • Diagnosis depends on a combination of symptoms, physical examination, blood tests
  • Treatment is aimed at relieving symptoms of dry eyes and mouth and preventing and treating long-term complications such as infection and dental disease.
  • Most patients with Sjögren’s syndrome remain healthy, but some people devlop rare serious complications
  • There may be an increased risk for cancer of the lymph glands (lymphoma). So regular medical care and follow up is important for all patients. But don’t worry as this is not seen in all sjogren patients.
  • Sjogren syndrome is an autoimmune disease where there is inflammation of different organs (mainly salivary and tear glands leading to dry eye and dry mouth) because of Immune attack.
  • Normally our Immune system attack outside invading organism like bacteria and Viruses etc and designed to protect our own body parts
  • In Sjogren syndrome, immune system become deregulated and attacks one’s own body parts or organs. Although it is not completely known, why this happens, there is contribution of multiple factors such as gene, environment, infection etc.
  • Many infections including a virus known as EB Virus known to trigger the autoimmune process in some patients having Sjogren syndrome.
  • The most common symptoms of Sjogren’s syndrome involve your eyes and mouth causing dryness in mouth and eyes (gritty sensation).
  • Because saliva helps protect the teeth from the bacteria that cause cavities, you’re more prone to developing cavities if your mouth is dry.
  • Fungal infections. People with Sjogren’s syndrome are much more likely to develop oral thrush, a yeast infection in the mouth.
  • Eye problems. Dry eyes if not treated with artificial eyedrops, may lead to blurred vision and corneal damage.
  • Less common complications might affect:
    • Lungs, kidneys or liver. This may lead to pneumonia, bronchitis or other problems in lungs; problems with kidney function
    • Nerves. Patients may develop numbness, tingling and burning in your hands and feet (peripheral neuropathy).
    • Malignancies. A small percentage of people with Sjogren’s syndrome develop cancer of the lymph nodes (lymphoma).
  • • Like other autoimmune diseases, Diagnosis depends on a combination of symptoms, physical examination, blood tests
  • • Special tests for assessing any decrease in tear production like Schrimer tests or Tear break up time test etc performed by eye specialist
  • • ANA profile test is a special test done to determine presence of specific autoantibody in blood (Anti Ro and Anti La antibodies).
  • • If antibody tests are negative, Biopsies of minor salivary glands under the surface of the inner lip is done to confirm a diagnosis.
  • Treatment is mainly aimed at relieving symptoms
  • Dry eyes usually treated with artificial tears applied regularly during the day or gels applied at night. In severe cases anti-inflammatory eyedrops like cyclosporine may be used.
  • Drinking frequent sips of water, chewing gum, or using saliva substitutes may relieve dry mouth. Pilocarpine and cevimuline are drugs that increase secretion from salivary and lacrimal glands. So they can be used in severe cases.
  • Frequent brushing of teeth, maintaining oral hygiene is very important to prevent dental caries. Humidifiers and nasal saline irrigation may improve nasal dryness.
  • Hydroxychloroquine , may be helpful in most patients with Sjögren’s syndrome to reduce joint pain, rash and fatigue.
  • Patients with serious symptoms, such as fever, refractory rashes, abdominal pain, or lung or kidney problems, may require treatment with corticosteroids such as prednisone and/or immunosuppressive drugs like methotraxate, azathioprine, Mycophenolate or rituximab etc.
  • At OARC, we offer holistic care to patients suffering from all kind of arthritis and autoimmune diseases by our renowned rheumatologist.
  • Because of chronic illness of the disease, we spend some time with the patient helping them to know about their disease, and demystify the myths regarding the disease and treatment.
  • We have collaboAStion with NABL accredited laboAStory where all kind of blood tests can be done at reasonable costs.
  • We also have patient support system where patient can approach in case of any emergency.
  • We believe in a friendly relation with patients so that they can share all their sufferings and get the best possible treatment.