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.

It is classified as a systemic autoimmune disease.

This disease is often seen in women – almost 90% of the time.

Disease often has an onset age of over 40.

The disease 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

No known cure

Goal is to control inflammation process of this disease and to improve symptoms.

.  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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