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

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