Sjogren’s Syndrome is a disease where the immune cells from the Immune System of the body attack one’s own exocrine glands – especially those that produce tears and saliva. This is really the hallmark of the syndrome – ability to produce tears and saliva. But there are other symptoms as well. It is classified as a systemic autoimmune disease.
This disease is often seen in women – almost 90% of the time. And this disease often has an onset age of over 40.
Sjogren’s Syndrome can affect any men and women of any age. More than 4 million Americans are effected by this disease.
Types:
1.) Primary Sjogren’s syndrome
2.) Secondary
– Can be a secondary disease, years after onset of another associated rheumatic disorder such as: Rheumatoid Arthritis, Lupus Erythematosus, Scleroderma, Biliary cirrhosis, others.
Symptoms
– Can be difficult – a wide variety of symptoms can be seen
– Generalized Dizziness – Hallmark
– Dry mouth
– Dry cough
– Dry eyes
– Skin dryness
– Rash
– Nose dryness
– Vaginal dryness
– Organ involvement with possible damage: Lungs, Liver, Kidney, Blood vessels, Pancreas, and others
– Fatigue
– Swollen salivary glands
– Joint pain
Diagnosis
Cerebrospinal fluid
– An elevated IL-IRA (Interleukin-1 receptor antagonist) which may be a marker for fatigue.
Blood work
– Increased levels of ANA (anti-nuclear antibody) and rheumatoid factor can be seen – both are associated with autoimmune diseases
Schirmer test
– Measures the production of tears
– A strip of filter paper is placed inside the lower eyelid for a 5 minute period.
– When a low amount is analyzed – often is indicative of Sjogren’s syndrome.
Ultrasound
– Examination of salivary glands – simplest confirmatory test.
– Small lesions in the gland will be seen.
– Stones inside salivary gland can be seen. (Sialectasis)
Treatment
1.) No known cure
2.) Goal is to control inflammation process of this disease and to improve symptoms.
3.) Medications
. Artificial tears
. Ciclosporin – [Restasis] – medication to help treat dry eye
. Cebimeline – [Evoxac] – medication to help stimulate salivary flow
. Pilocarpine – helps stimulate salivary flow
. NSAID – Help with pain in joints and musculoskeletal symptoms
. Steroids [corticosteroids] – treat advance cases/symptoms
. Immunosuppressive drugs – treat advance cases/symptoms
. Methotrexate
. Hydroxychloroquine [Plaquenil] – Disease modifying anti-rheumatic agents (DMARDs)
. Others