Sjogren’s Syndrome
Sjogren’s (SHOW-grins) syndrome is an autoimmune disease that attacks and destroys salivary glands and lacrimal glands. These glands are responsible for keeping the eyes, mouth and other parts of the body moist and lubricated. Patients may notice irritation, burning sensation in eyes and Dry mouth. Some patients may also experience dryness in Throat, nasal passages, skin and vagina. It affects people of any age and is most common in older women. Sjogren’s syndrome is often accompanied by other autoimmune disorders such as lupus and Rheumatoid arthritis.
Sjogren’s is a systemic disorder, which means it affects whole body. The immune system primarily attacks the glands that produce tears and saliva. It can also cause dysfunction of organs like kidneys, lungs, liver, pancreas, gastrointestinal system and the central nervous system. Also, there is an increased risk for lymphoma (cancer of lymphatic system). It can develop at any age and women are much more likely to have Sjogren’s syndrome.
There are 2 types of Sjogren syndrome— Primary and Secondary.
Primary Sjogren syndrome occurs in people with no other autoimmune disease, it develops alone. The symptoms with primary are Dry eyes and Dry mouth. Secondary Sjogren syndrome occurs along with other autoimmune diseases, such as lupus, rheumatoid arthritis or Celiac disease.
Cause
Sjogren syndrome is an autoimmune disease. It means that our immune system mistakenly attacks the healthy cells and tissues of the body. However, in the case of Sjogren syndrome your immune system attacks the glands that make tears and saliva. Researchers believe that it is triggered by environmental, genetic and hormonal factors.
Symptoms
- Dry and burning sensation in eyes- Patients with Dry eyes are at increased risk for infections around the eye and may have damage to the cornea.
- Dry mouth/ Xerostomia: Dry mouth may cause an increase in dental decay, oral thrush, gingivitis.
- Parotid Gland enlargement
- Fatigue/ tiredness
- Joint pain
- Sore or Dry Skin
- Dry or peeling lip
- Vaginal Dryness
- Dry Nose
Diagnosis
Early diagnosis is extremely important to prevent damage to major organs. Since symptoms of RA mimic other conditions it can be mistaken for other conditions so diagnosis of Rheumatoid arthritis becomes difficult. Several tests that can be done for the diagnosis are blood test, Lip biopsy, ocular surface staining
Schirmer’s test- In Schirmer’s test, a tiny strip of blotting paper is placed under the lower eyelid to measure the amount of tears your eye makes within 5 minutes.
Sialography- It is an x- ray of salivary glands and ducts.
Treatment
There is no known cure of Sjogren’s syndrome. However, Symptoms can be controlled. Many symptoms like Dry eyes and Dry mouth can be managed by over-the-counter medications. If these are not effective, prescription products for Dry eyes and mouth are available.
- Dry mouth: Chewing sugar free gums stimulates saliva production. Sipping water frequently and sucking ice cubes lubricates the mouth and reduce dryness. If these are not effective saliva substitutes can be helpful. It lubricates the mouth and alleviates dryness and pain. These are available in spray, gel, lozenges and gum. It is important to maintain proper dental hygiene to avoid dental decay.
- Dry eyes: Artificial Tears and eye lubricant ointments may be recommended. It helps to lubricate the eyes. Cyclosporine eye drops reduces the inflammation of glands. In some cases, an eye specialist may suggest Punctal Occlusion. In this tiny collagen plugs are inserted into the lacrimal ducts. Plugging the lacrimal duct with collagen plug can be effective. It seals the tear duct into which the tear drains. All medication that reduces the tear flow should be avoided.
- Pain and inflammation: NSAIDs — aspirin and ibuprofen provides relief from joint and muscle pain. In Severe Cases Corticosteroids or Immunosuppressive drugs may be prescribed.
- Vaginal Dryness: Vaginal lubricants can ease vaginal dryness.
- Use a humidifier at night.
- Dry Lips- For dry lips, apply petroleum jelly.
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