Sjogren's Syndrome

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Sjogren's Syndrome
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Overview

Overview

Sjogren’s syndrome is an autoimmune condition, which means that the body produces proteins, called antibodies, which attack normal cells, tissues and organs. The condition is characterized by two common symptoms, and they include a dry mouth and dry eyes.

Sjogren’s syndrome can accompany other autoimmune conditions such as lupus and rheumatoid arthritis.

The condition can cause complications such as dental cavities due to a dry mouth, visual problems as a result of the decreased lubrication of the eyes, and yeast infections of the mouth. Other complications may develop from Sjogren’s syndrome affecting other organs and tissues such as respiratory conditions like pneumonia and bronchitis, hepatitis, kidney failure, peripheral neuropathy, and lymphoma.

Epidemiology

Sjogren’s syndrome usually occurs in people over the age of 40, but it can develop at any time. Females are also more commonly affected than males.

Causes

Sjogren’s syndrome occurs as a result of antibodies first attacking the mucous membranes and moisture-producing glands in the mouth and eyes. The cause of this immune-mediated response is not known, but it’s thought that certain genetic factors and environmental triggers, such as infection with a specific strain of bacteria or virus, are linked to the development of this disease.

Other organs and tissues that can also be affected in Sjogren’s syndrome include the thyroid gland, joints, liver, nerves, lungs, kidneys, and the skin.

Signs and symptoms

The two main areas of involvement in Sjogren’s syndrome are the mouth and eyes. Signs and symptoms of the condition include a dry mouth that feels like one is chewing on cotton and this makes it difficult to speak or swallow, and the eyes can feel itchy or burning or it may feel gritty like there’s sand in the eyes.

Other signs and symptoms experienced by patients with Sjogren’s syndrome may include swollen saliva-producing glands (especially in front of the ears or behind the jaw), joint pain and swelling, vaginal dryness, prolonged fatigue, skin rashes, persistent dry cough, or dry skin.

Diagnosis

Sjogren’s syndrome seems to be a diagnosis of exclusion because numerous conditions can mimic the presentation of the disease. The condition should be suspected though when patients present with the mentioned signs and symptoms together with a history of being diagnosed with other autoimmune conditions.

Blood tests can be performed to detect antibodies common in Sjogren’s syndrome, as well as monitor the functioning of the liver and kidneys. Eye dryness can also be measured by performing the Schirmer tear test. A sialogram is performed to determine how the salivary glands are functioning. A biopsy of affected tissue, such as the mucous membranes in the mouth, can be obtained to look for inflammatory cells indicating Sjogren’s syndrome.

Management

There is no cure for Sjogren’s syndrome, but the condition can be managed effectively enough through controlling the symptoms caused by the disease.

Dry eyes can be managed with over-the-counter eye drops, and a dry mouth can be lubricated by taking frequent sips of water. In some cases though, certain medications and even surgery may be indicated.

Cevimeline and pilocarpine can be prescribed to increase saliva production, and these medications may even help produce tears to lubricate the eyes. Yeast infections in the mouth can be managed with antifungal drugs, and arthritic issues can be managed with non-steroidal anti-inflammatory medications.

Methotrexate is a drug that can be used to help suppress the immune system to reduce the production of antibodies caused by Sjogren’s syndrome.

Surgery involves sealing the tear ducts that drain tears from the eyes, so that they can accumulate and lubricate this area.