Sjogren’s Syndrome, Symptoms and Treatment

Sjögren’s syndrome is an autoimmune disease in which the immune system is activated against the body’s own tissues.

Inflammation is the body’s normal response to injury or infection. Edema, redness, and temperature increase after an incision or crush are signs of inflammation.

In Sjögren’s syndrome, inflammation takes place mainly in the salivary and secretory-producing glands of the body. As a result, the complaint of dry eyes and mouth occurs. As a result of the involvement of glands elsewhere in the body, dryness may develop in the skin, throat, respiratory tract, intestines and vagina.

If Sjögren’s syndrome exists alone without any other disease, it is called primary Sjögren’s syndrome. If it is associated with another disease such as rheumatoid arthritis , lupus, systemic sclerosis , it is classified as secondary Sjögren’s syndrome.

Sjögren’s syndrome is most common in women aged 40-60 years. Only one-tenth of people with Sjögren’s syndrome are male.

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Symptoms

The most common symptoms are dry eyes, dry mouth, weakness and pain. Symptoms can vary from person to person. While it is mild for some people, it can be heavy enough to make daily life difficult for others.

There may be a feeling of sand in the eyes, dryness, discomfort from bright light, thick tears, swelling of the eyelids, pain, blurred vision. If dry eyes are not treated, it can lead to eye damage and permanent vision problems.

Complaints such as dryness in the mouth, sore formation, sticking in the throat, difficulty in swallowing, change in the sense of taste, desire to drink water while eating something, hoarseness, dry cough can be seen. Having a very dry mouth can lead to additional problems such as fungal infection and tooth decay. The saliva-producing parotid glands, located in front of the ears on the face, may be swollen and painful.

Fatigue and weakness that cannot be associated with any reason can be seen. Both physical and mental fatigue can lead to a lack of concentration. Illness and fatigue can ultimately lead to depression.

There may be pain and swelling in the joints due to inflammation, pain and tenderness in the muscles.

Dryness of other parts of the body may cause symptoms such as irritable bowel syndrome (abdominal bloating, diarrhea, constipation), urination, bladder pain-restlessness, vaginal dryness, pain during sexual intercourse, skin itching, sun sensitivity, dry cough, sensitivity to dust and smoke. .

Why Does It Happen?

In Sjögren’s syndrome, the immune system is activated against glands that produce secretions in the body. Lacrimal glands and salivary glands are the most frequently involved sites. As a result of inflammation, there is a decrease in gland secretions. It is thought that the disease develops on the basis of genetic predisposition, but this does not mean that a person with Sjögren’s disease will have this disease. Since it is more common in women, it is thought that estrogen hormone may also play a role.

Additional Problems

Raynaud’s phenomenon is a problem with paleness, bruising and redness of the fingers due to cold exposure.

Hypothyroidism may develop due to underactivity of the thyroid gland.

Inflammation of the vessel wall (vasculitis) may develop and as a result, the blood supply to the tissues may be impaired.

Loss of sensation in the hands and feet may occur as a result of nerve ending inflammation (peripheral neuropathy).

There may be kidney problems.

Liver problems such as primary biliary cholangitis may develop.

Purple spots (purpura) may occur on the legs.

Pleurisy, which causes chest pain and shortness of breath, may occur.

There may be problems such as enlargement of the airways (bronchiectasis), susceptibility to lung infections.

Celiac disease, an autoimmune condition in which the intestines react to gluten, may develop.

Very rarely, people with Sjögren’s syndrome may develop lymphoma (cancer of the lymph nodes).

Diagnosis

It can be difficult to diagnose because it is a rare disease and usually not all symptoms are present together. Sjögren’s syndrome falls within the field of Rheumatology. In general, patients apply to the eye, ear nose and throat, internal medicine or physical therapy and rehabilitation departments according to the nature of their complaints. If Sjögren’s syndrome is suspected as a result of questioning the complaints and physical examination, some examinations are performed. A test that measures tear production may be done. The amount of saliva secretion can be tested. Signs of inflammatory processes can be investigated by imaging the salivary glands with ultrasonography or MRI. Inflammation and rheumatism markers can be investigated in the blood. Anti-Ro and anti-Lo autoantibodies in the blood may help the diagnosis. In a salivary gland biopsy, a small piece of the lip can be taken and the salivary glands can be examined under a microscope.

Treatment

Although there is no cure for Sjögren’s syndrome, there are treatments to control symptoms and disease activity.

Drop treatments containing artificial tears may be recommended for dry eyes. Oil- or gel-based remedies may be needed for very dry eyes. In case of inflammation, cyclosporine or corticosteroid drops can be prescribed by the doctor. Depending on the problems experienced, the ophthalmologist may also apply other treatments.

If bright lights are bothering you, wearing sunglasses can help. Windy and smoky environments should be avoided. A humidifier can be used to increase the ambient humidity.

Regular check-ups should be made at the dentist for oral health.

Exercises can be recommended for people with joint complaints. Regular exercise can also reduce symptoms such as fatigue and lack of concentration.

If there are intestinal problems, it may be beneficial to increase the fiber content in foods.

Various drug treatments can be recommended by the doctor according to the symptoms and activity of the disease.

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