Sjogren’s Syndrome: Here is All You Need to Know About It

The world celebrates 8^th Sjogren’s Day on 23^rd July 2019 in order to remember Dr. Henrik Sjogren’s birthday. He was a Swedish ophthalmologist who discovered this syndrome, named after him.

What is Sjogren’s Syndrome?

Pronounced as Show-grins, this syndrome is an autoimmune disease. It is a disorder of immune system whose main symptoms are dryness in eyes and mouth.

In autoimmune diseases, there is abnormal generation of extra antibodies in the blood and these are directed against different tissues of human body. The misguided immune system in autoimmunity often leads to tissue infections.

This autoimmune disease causes inflammations and debilitation in tears and saliva producing glands. This inflammation causes a reduction in production of water for tears and eventually the person affected faces the problem of dry eyes. This inflammation also causes dry mouth and lips in patients as the saliva production is decreased.

Sjogren's syndrome which causes dryness in mouth and eyes (gland inflammatory) but is not related to other connective tissue illness is known as primary Sjogren syndrome. In cases where connective tissue disease also comes into picture, like scleroderma, rheumatoid arthritis, etc., such cases are known to be of secondary Sjogren’s syndrome.

The cases where the patient suffers from dry eyes and mouth without having Sjogren’s syndrome, are known as Sicca syndrome cases.

Some facts about Sjogren’s Syndrome:

The 2 key symptoms of Sjogren’s syndrome are:

• Dry eyes: a burning sensation, itchiness or redness in eyes. A feeling of something constantly bothering your eyes, like sand or other small irritable elements are there in eyes.
• Dry mouth and lips: dryness in lips and difficulty swallowing or speaking. Irritability in throat.

Other than these 2 main symptoms, a patient can also have below-mentioned symptoms:

• Dry skin or rashes
• Chronic coughing or never-ending cough
• Stiffness in joints or pain and swelling
• Dryness in vagina
• Swelling in salivary gland- especially in parts behind the jaw and in front of ears
• Constant fatigue

Let’s have a detailed look at the signs and symptoms of this disease:

Mainly the glands, as mentioned above, are the target of this disease, however, there are other possible effects too which involve other body organs, a condition known as extra-glandular manifestations. When the lacrimal gland (the gland responsible for producing tears) is infected from Sjogren’s syndrome, the dryness in eyes can lead to other symptoms like irritation in eyes, reduction in production of tears, eye infections and severe scraping of cornea. Dryness in eyes can also lead to blepharitis (infection in eyelids). When there is inflammation in eyes due to dryness, it is known as keratoconjunctivitis sicca.

When the salivary glands are infected, it can cause:

• Dryness in mouth
• Dental decaying
• Problem in swallowing
• Swelling in mouth and mouth sores
• Cavities
• Loss of taste/ issues with taste buds
• Damaged voice or hoarseness
• Dry cough

Other glands that can be affected, though less common, are the linings of breathing passages; which can cause lung infections and vagina, leading to frequent vaginal infections and pain during sexual intercourse.

The extra-glandular issues occurring due to Sjogren’s syndrome can be tiredness, pain in joints or soreness, lung infections, elongation of lymph node, kidney, nerve and muscular diseases with weakness and pain in muscles. A very rare effect or complication arising due to this syndrome is infection in blood vessels (vasculitis), which impairs the tissues being supplied by these vessels.

A very common illness related to Sjogren’s syndrome is autoimmune thyroiditis, which can cause anomalous thyroid hormone levels which are diagnosed through thyroid blood tests. Gastroesophageal reflux disease (GERD) can occur due to issues with swallowing and heartburn because of this syndrome.

An unlikely and grave disease that is related with Sjogren’s syndrome is primary biliary cirrhosis which is an autoimmune disease of liver causing scarring of the liver tissue.

Some people suffering from Sjogren’s syndrome can also develop cancer of lymph glands. This happens when the person has been living with this syndrome for many years.

Causes of Sjogren’s Syndrome

The real and specific cause of this syndrome is yet to be identified. Though there is strong evidence suggesting that it might be genetic. Certain genetic factors might lead to development of this syndrome, and the genetic background of Sjogren’s syndrome patients is being researched upon. The disease is diagnosed in other family members sometimes. This condition is also common in families that have people suffering from other type of autoimmune diseases like autoimmune thyroid disease, systemic lupus erythematosus, type 1 diabetes, etc.

Sjogren’s syndrome’s main target is the tears and saliva producing glands of your body, but it can also affect other body parts such as the liver, kidney, skin, thyroid, nerves, joints and lungs.

Who are at the risk of developing Sjogren’s Syndrome?

Though anyone can be affected by this syndrome, chances are higher for people who have any case of their family member(s) suffering from any kind of autoimmune disease, though it is not necessary. But certain genes inherited can put some individuals at the risk of developing this syndrome. Sjogren’s syndrome can also be spasmodic can develop in an individual with no family history of any autoimmunity.

Treatment for Sjogren’s Syndrome

The treatment for this disease is focused on specific body parts/areas that are affected and prevention of further complications like infections. At present, this syndrome is not curable.

The issue of dry eyes can be taken care of by using artificial tears, eye lubricants/ointments during nighttime and reducing the usage of hair dryers. When the dryness becomes more problematic, the ophthalmologist can go for plugging the tear duct shut so the tears can stay for a longer duration of time and cover the eyes, avoiding the dryness.

Cyclosporine eyedrops are authenticated eyedrops that help in reducing the soreness of tear glands and help them function properly. Any infection in eyes or any kind of soreness or redness in eyes and pus and pain should be examined by the physician.

Some significant changes to the diet can be made like adding flaxseed oil to the diet in order to help relieve the dryness in eyes. For those who suffer from the deficiency of Vitamin D especially, Vitamin D supplements can be prescribed.

To control the dryness in mouth, drinking good amount of fluids and air humidifying can be good options along with taking care of the oral and dental health to prevent dental decay. For salivary glands to produce required amount of saliva and function properly, stimulation can be done by sucking sugar free lemon drops or glycerin swabs. Apart from these, there are certain medicines provided to control the symptoms of dry mouth; these medicines work as saliva stimulants, like pilocarpine (Salagen) and cevimeline (Evoxac). People suffering from ailments like asthma or glaucoma and other heart diseases should refrain themselves from using these medications.

Making artificial saliva can control the problem of dry mouth to a great extent. Many of such elements are available as OTC products (Over the counter), inclusive of chewing gums, toothpaste and mouthwash. Lozenges and Numoisyn Liquid also serve the purpose of treating dry mouth. Infection being developed in mouth and teeth should be taken care off immediately in order to avoid further complications. Dental care is very important. Damp and warm compresses can be used for massaging the parotid glands as it will help in soothing the pain and swelling.

For fatigue and joint pains especially, Hydroxychloroquine (Plaquenil) has proved to be efficient for few symptoms of Sjogren’s syndrome. For conditions like vasculitis, immune-suppressing medicines, inclusive of azathioprine (Imuran) or cortisone (prednisone) and/or cyclophosphamide (Cytoxan) can be given. In cases where the patient develops lymphoma (cancer of lymph nodes), the treatment is independent.

Turacoz Healthcare Solutions aims to raise awareness regarding Sjogren’s syndrome in order to promote healthier living. Being in the medical communications business, we feel that we have a responsibility towards everyone in the society to be aware of all the diseases and their possible treatments and diagnosis.

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