Sjogrens Syndrome Facts

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Sjogrens (pronounced show grins) syndrome is an autoimmune disease which sometimes overlaps with lupus. It can cause a myriad of issues and is not well known by the public. In an effort to educate, I am presenting this article, taken form the www.sjogrens.org website. Please read and learn. Thanks!

 

About Sjögren’s Syndrome

Sjögren’s syndrome is a chronic autoimmune disease in which people’s white blood cells attack their moisture-producing glands. Today, as many as four million Americans are living with this disease.

Although the hallmark symptoms are dry eyes and dry mouth, Sjögren’s may also cause dysfunction of other organs such as the kidneys, gastrointestinal system, blood vessels, lungs, liver, pancreas, and the central nervous system. Patients may also experience extreme fatigue and joint pain and have a higher risk of developing lymphoma.

With upwards of 4,000,000 Americans suffering from Sjögren’s syndrome, it is one of the most prevalent autoimmune disorders. Nine out of 10 patients are women.

About half of the time Sjögren’s syndrome occurs alone, and the other half it occurs in the presence of another autoimmune connective tissue disease such as rheumatoid arthritis, lupus, or scleroderma. When Sjögren’s occurs alone, it is referred to as “Primary Sjögren’s.” When it occurs with another connective tissue disease, it is referred to as “Secondary Sjögren’s.”

All instances of Sjögren’s syndrome are systemic, affecting the entire body. Symptoms may remain steady, worsen, or, uncommonly, go into remission. While some people experience mild discomfort, others suffer debilitating symptoms that greatly impair their functioning. Early diagnosis and proper treatment are important — they may prevent serious complications and greatly improve a patient’s quality of life.

Since symptoms of Sjögren’s syndrome mimic other conditions and diseases, Sjögren’s can often be overlooked or misdiagnosed. On average, it takes nearly seven years to receive a diagnosis of Sjögren’s syndrome. Patients need to remember to be pro-active in talking with their physicians and dentists about their symptoms and potential treatment options.

Since the disease was first identified in 1933 by Dr. Henrik Sjögren, it has been proven to affect virtually every racial and ethnic group. General awareness about Sjögren’s syndrome is still lacking and increased professional awareness is needed to help expedite new diagnoses and treatment options.

Symptoms

Sjögren’s syndrome is a systemic disease, and its symptoms are felt throughout the entire body.

Sjogren's body symptoms

Symptoms vary from person to person but may include:

  • a dry, gritty or burning sensation in the eyes
  • dry mouth
  • difficulty talking, chewing or swallowing
  • a sore or cracked tongue
  • dry or burning throat
  • dry or peeling lips
  • a change in taste or smell
  • increased dental decay
  • joint pain
  • vaginal and skin dryness
  • digestive problems
  • dry nose
  • fatigue
Diagnosis

Early diagnosis and treatment are important for preventing complications. Unfortunately, reaching a diagnosis can often be difficult and has been found to take an average of 6.5 years from the onset of symptoms.

Sjögren’s syndrome symptoms frequently overlap with or “mimic” those of other diseases including lupus, rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome, and multiple sclerosis. Dryness can also occur for other reasons, such as a side effect of medications such as anti-depressants and high blood pressure medication.

There is no single test that will confirm diagnosis. Rheumatologists have primary responsibility for diagnosing and managing Sjögren’s syndrome and can conduct a series of tests and ask about symptoms. An international group of experts formulated classification criteria for Sjögren’s syndrome which help doctors arrive at a diagnosis. These criteria consider dryness symptoms, changes in salivary (mouth) and lacrimal (eye) gland function, and systemic (whole body) findings.

Blood tests your physician may perform include:

  • ANA (Anti-Nuclear Antibody)
    ANAs are a group of antibodies that react against normal components of a cell nucleus. About 70% of Sjögren’s patients have a positive ANA test result.
  • RF (Rheumatoid Factor)
    This antibody test is indicative of a most often performed for the diagnosis of rheumatoid arthritis (RA)  but is positive in many rheumatic diseases. In Sjögren’s patients, 60-70% have a positive RF.
  • SS-A (or Ro) and SS-B (or La)
    These are the marker antibodies for Sjögren’s. Seventy percent of Sjögren’s patients are positive for SS-A and 40% are positive for SS-B (these may also found in lupus patients).
  • ESR (Erythrocyte Sedimentation Rate)
    This test measures inflammation. An elevated ESR indicates the presence of an inflammatory disorder, including Sjögren’s syndrome.
  • IGs (Immunoglobulins)
    These are normal blood proteins that participate in immune reactions and are usually elevated in Sjögren’s patients.

The ophthalmologic (eye) tests include:

  • Schirmer Test
    Measures tear production.
  • Rose Bengal and Lissamine Green
    Eyedrops containing dyes that an eye care specialist uses to examine the surface of the eye for dry spots.

The dental tests include:

  • Salivary Flow
    Measures the amount of saliva produced over a certain period of time.
  • Salivary scintigraphy
    A nuclear medicine test that measures salivary gland function.
  • Salivary gland biopsy (usually in the lower lip)
    Confirms inflammatory cell (lymphocytic) infiltration of the minor salivary glands.

Your physician will consider the results of these tests along with your physical examination to arrive at a final diagnosis. Further research is being conducted to refine the diagnostic criteria for Sjögren’s syndrome and to help make diagnosis easier and more accurate.

Treatments

Early diagnosis and high-quality professional care are extremely important for Sjögren’s patients.

Currently, there is no cure for Sjögren’s syndrome. However, treatments may improve various symptoms and prevent complications.

In addition to over the counter (OTC) eye drops and mouth preparations, prescription products for dry eyes and dry mouth are available. They include Evoxac® (cevimeline), Salagen® (pilocarpine hydrochloride) and Numoisyn™ for dry mouth and Restasis® (cyclosporine ophthalmic emulsion) and Lacrisert® (hydroxypropyl cellulose ophthalmic insert) for dry eye.

Some patients are prescribed immunosuppressive medications to treat their internal organ manifestations. Physicians may also prescribe other medications for systemic manifestations or severe flares. Since Sjögren’s syndrome affects each patient differently, a personalized plan should be developed by you and your physician, dentist and eye care specialist about how to treat your various symptoms.

In addition, many symptoms and problems of Sjögren’s syndrome can be treated with over-the-counter medications. These medications can help to alleviate different types of dryness and pain, but you should check with your physician when adding these medications to your regimen. He/she may have suggestions for what products you should use and may also give you some tips on how and when to use them.

For a listing of these and additional treatment options available, a Product Directory is available to Foundation members in the Member Community section of our website.

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