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Sjogren's Syndrome

 
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Definition of Sjogren's Syndrome

An autoimmune disorder that results in chronic dysfunction of exocrine (secretory) glands in many areas of the body.

Description of Sjogren's Syndrome

Sjogren's syndrome is a chronic (lifelong) disorders that causes dry eyes and a dry mouth. It is named after the Swedish eye doctor, Dr. Henrick Sjogren, who first described it.

Sjogren's syndrome generally occurs in two ways: primary and secondary.

    Primary Sjogren's syndrome occurs by itself and is not associated with other diseases.

    Secondary Sjogren's syndrome occurs with rheumatic diseases such as rheumatoid arthritis, systemic lupus erythematous ("lupus"), polymyositis, and some forms of scleredema. Rheumatic diseases are conditions that affect joints, bones, muscles, skin, and sometimes other organs.

In Sjogren's syndrome, changes occur in the immune system - the body's defense against disease. The immune system lacks the usual controls. This causes white blood cells to invade glands in the body that produce moisture, such as the tear and salivary glands, and the Bartholin's glands in the vagina. They can destroy the glands and cause them to stop producing moisture.

Sjogren's syndrome can also cause problems in other parts of the body, including the joints, lungs, muscles, kidneys, nerves, thyroid gland, liver, pancreas, stomach and brain.

Causes and Risk Factors of Sjogren's Syndrome

About 90 percent of patients are women. The peak incidence is between the ages of 40 and 60.

Symptoms of Sjogren's Syndrome

In people with no other health problems, the most common early symptom is the onset of severe dry mouth and eyes. In people with rheumatoid arthritis or related conditions, dry eyes and mouth develop more slowly. In this case, Sjogren's may be difficult to diagnose.

Sjogren's syndrome affects everyone differently.

Dry mouth. The mouth normally contains saliva, which aids chewing and swallowing. In people with Sjogren's syndrome, the amount of saliva is reduced. This makes chewing, swallowing and speaking difficult. It may also cause a decreased sense of taste.

Dry eyes. Eyes may feel dry, "gritty" or "sandy". They may burn and look red. A thick substance may accumulate in the inner corner of your eyes while you sleep. Your eyes may be more sensitive to sunlight. If not properly treated, Sjogren's syndrome can lead to ulcers of the cornea (the clear covering of the eyeball). On rare occasions, this can cause blindness.

Swollen salivary glands. There are three sets of glands that produce saliva. They're located under your tongue, in the cheeks in front of your ears, and in the back of your mouth. They may feel swollen and tender. This may occur along with a fever. This affects about one-half of people with the disorder.

Dental cavities. This is a common problem that results from a dry mouth. Saliva fights bacteria and defends against cavities. Because you have decreased saliva, your teeth may develop cavities more easily.

Dry nose, throat, and lungs. This may make your throat feel dry. You may have a dry cough, hoarseness, a decreased sense of smell, and nosebleeds. It can also lead to pneumonia, bronchitis, and ear problems.

Dryness of the vagina. This can cause painful intercourse.

Fatigue. is a common complaint. You may get easily exhausted and feel tired and worn out.

Other problems. Sjogren's syndrome can affect other parts of the body, such as blood vessels, the nervous system, muscles, skin, and other organs. This can lead to muscle weakness, confusion and memory problems, dry skin, and feelings of numbness and tingling.

Some patients develop cancer of the lymph tissue.

Diagnosis of Sjogren's Syndrome

The diagnosis is often based on clinical findings. Blood tests may be performed. The Schirmer test, measures the quantity of tears secreted into the eye.

Treatment of Sjogren's Syndrome

As yet, there is no cure for Sjogren's syndrome. But proper treatment can help relieve symptoms so you can live a comfortable and productive life.

The main goal of treatment is to relieve discomfort and lessen the effects of the dryness. Since Sjogren's syndrome affects everyone differently, your treatment plan will be based on your specific needs. Your treatment may include different ways to relieve your symptoms, such as those listed below.

For dry mouth:

    Sip fluids throughout the day.

    Use sugar-free gum or candies to stimulate saliva production.

    Try saliva substitutes or mouth coating products. They may be useful in some people, and are available without a prescription.

To prevent dental cavities:

    Have frequent dental checkups.

    Use mouth rinses that contain fluoride.

    Brush and floss your teeth regularly.

    Use sugar-free products.

For dry eyes:

    Use artificial tears or eyedrops to help relieve the discomfort of dry eyes. Use preservative-free products, if you apply the drops more than four times per day.

    Try lubricating ointments or small, long-acting pellets for overnight or long-lasting relief.

    Your ophthalmologist may recommend a punctual occlusion. This is a simple operation that blocks tear drainage from your eye.

For dry skin:

    Use moisturizing lotions for sensitive skin.

    Avoid drafts from air conditioners, heaters, and radiators, when possible.

    Use a humidifier in your house and at work.

For vaginal dryness:

    Use lubricants made specifically to help vaginal dryness.

    Do not use petroleum jelly.

Questions To Ask Your Doctor About Sjogren's Syndrome

Is Sjogren's syndrome hereditary?

Do all symptoms have to occur at the same time for you to consider Sjogren's syndrome?

If arthritis is present, or other related conditions, is having Sjogren's syndrome probable?

Can Sjogren's syndrome be prevented?

How often should follow-up be done?

What is the prognosis?



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Nov 21, 2008
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