Sjogren’s (SHOW-grins) syndrome is a disorder of your body immune system determined by its two most typical symptoms– dry eyes and a dry mouth.
Sjogren’s syndrome frequently accompanies other body immune system conditions, such as rheumatoid arthritis and lupus. In Sjogren’s syndrome, the mucus membranes and moisture-secreting glands of your eyes and mouth are normally affected first– resulting in reduced production of tears and saliva.
Although you can develop Sjogren’s syndrome at any age, most people are older than 40 at the time of diagnosis. The condition is much more common in women. Treatment concentrates on relieving symptoms.
Sjogren’s Syndrome Symptoms
The two main symptoms of Sjogren’s syndrome are:
- Dry eyes. Your eyes may burn, itch or feel gritty– as if there’s sand in them.
- Dry mouth. Your mouth might feel like it’s complete of cotton, making it tough to swallow or speak.
Some people with Sjogren’s syndrome also experience several of the following:
- Joint pain, swelling and stiffness
- Swollen salivary glands– especially the set located behind your jaw and in front of your ears
- Skin rashes or dry skin
- Vaginal dryness
- Persistent dry cough
- Extended fatigue
Sjogren’s Syndrome Causes
Sjogren’s syndrome is an autoimmune disorder. This indicates that your immune system wrongly attacks your body’s own cells and tissues.
Researchers aren’t certain why some people develop Sjogren’s syndrome and others do not. Particular genes put people at higher risk of the disorder, but it appears that a triggering system– such as infection with a particular virus or strain of bacteria– is likewise required.
In Sjogren’s syndrome, your immune system first targets the moisture-secreting glands of your eyes and mouth. But it can also harm other parts of your body, such as your:
- Joints
- Thyroid
- Kidneys
- Liver
- Lungs
- Skin
- Nerves
Risk factors
Although anybody can establish Sjogren’s syndrome, it normally happens in people with several known risk factors. These consist of:
- Age. Sjogren’s syndrome is usually diagnosed in people older than 40.
- Sex. Women are far more most likely to have Sjogren’s syndrome.
- Rheumatic disease. It’s common for people who have Sjogren’s syndrome to likewise have a rheumatic disease – such as rheumatoid arthritis or lupus.
Complications
The most typical complications of Sjogren’s syndrome involve your eyes and mouth.
- Dental cavities. Due to the fact that saliva helps secure the teeth from the bacteria that cause cavities, you’re more susceptible to developing cavities if your mouth is dry.
- Yeast infections. People with Sjogren’s syndrome are far more most likely to establish oral thrush, a yeast infection in the mouth.
- Vision problems. Dry eyes can lead to light level of sensitivity, blurred vision and corneal ulcers.
Less typical complications may impact your:
- Lungs, kidneys or liver. Swelling may cause pneumonia, bronchitis or other problems in your lungs; may cause issues with kidney function; and may cause hepatitis or cirrhosis in your liver.
- Lymph nodes. A small percentage of people with Sjogren’s syndrome establish cancer of the lymph nodes (lymphoma).
- Nerves. You may establish numbness, tingling and burning in your hands and feet (peripheral neuropathy).
Diagnosis
Sjogren’s syndrome can be tough to detect because the signs and symptoms differ from person to individual and can be just like those brought on by other illness. Side effects of a number of medications also simulate some symptoms and signs of Sjogren’s syndrome.
A range of tests can help eliminate other conditions and assist pinpoint a medical diagnosis of Sjogren’s syndrome.
Blood tests
Your doctor may order blood tests to look for:
- Levels of different types of blood cells
- Existence of antibodies typical in Sjogren’s syndrome
- Proof of inflammatory conditions
- Indications of issues with your liver and kidneys
Eye tests
Your doctor can determine the dryness of your eyes with a test called a Schirmer tear test. In this test, a small piece of filter paper is put under your lower eyelid to determine your tear production.
A doctor focusing on the treatment of eye disorders (ophthalmologist) might also take a look at the surface area of your eyes with a magnifying device called a slit light. He or she might put drops in your eye that make any damage to your cornea easier to see.
Imaging
Particular imaging tests can inspect the function of your salivary glands.
- Sialogram. An unique X-ray called a sialogram can spot color that’s injected into the salivary glands located in front of your ears. This procedure shows how much saliva flows into your mouth.
- Salivary scintigraphy. This nuclear medication test includes the intravenous injection of a radioactive isotope, which is tracked throughout an hour to see how rapidly it shows up in all your salivary glands.
Biopsy
Your doctor might likewise want to do a lip biopsy to detect the presence of clusters of inflammatory cells, which can show Sjogren’s syndrome. For this test, a little sliver of tissue is eliminated from salivary glands located in your lip and examined under a microscope.
How Is Sjogren’s Syndrome Treated
Many people can handle the dry eye and dry mouth associated with Sjogren’s syndrome by using over the counter eyedrops and drinking water more frequently. But some people may require prescription medications, and even surgery.
Medications
Depending on your symptoms, your doctor may recommend medications that:
- Increase production of saliva. Drugs such as pilocarpine (Salagen) and cevimeline (Evoxac) can increase the production of saliva, and sometimes tears. Side effects might consist of sweating, abdominal pain, flushing and increased urination.
- Address specific complications. If you develop arthritis symptoms, you might gain from nonsteroidal anti-inflammatory drugs (NSAIDs) or other arthritis medications. Prescription eyedrops might be required if over-the-counter drops aren’t valuable. Yeast infections in the mouth should be treated with antifungal medications.
- Treat systemwide symptoms. Hydroxychloroquine (Plaquenil), a drug developed to treat malaria, is frequently helpful in treating Sjogren’s syndrome. Drugs that reduce the body immune system, such as methotrexate, also might be prescribed.
Surgery
To eliminate dry eyes, you might consider going through a small surgical procedure to seal the tear ducts that drain tears from your eyes (punctal occlusion). Collagen or silicone plugs are placed into the ducts for a temporary closure. Collagen plugs eventually dissolve, but silicone plugs remain in location until they fall out or are removed. Alternatively, your doctor may use a laser to completely seal your tear ducts.
