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Sjogren’s

Sjogren’s syndrome is a chronic autoimmune disease where white blood cells attack moisture-producing glands, leading to dry eyes and mouth. It affects about 0.5% of the adult population. Early diagnosis and management are crucial to alleviate symptoms and prevent complications, improving the quality of life for those affected.

The exact causes of Sjogren’s syndrome are unknown, but it is believed to result from a combination of genetic, environmental, and hormonal factors. Genetic predisposition may increase susceptibility, while environmental triggers like viral infections could initiate the autoimmune response. Hormonal influences, particularly in women, also play a role in the development of Sjogren’s syndrome.

In the autoimmune attack that causes Sjogren’s, disease-fighting white blood cells called lymphocytes target the glands that produce moisture - primarily the lacrimal (tear) and salivary (saliva) glands. Although no one knows exactly how damage occurs, damaged glands can no longer produce tears and saliva, and eye and mouth dryness result.


 

Symptoms of Sjogren’s syndrome include:

  • Dry, gritty, or burning sensation in the eyes
  • Dry mouth
  • Dry or burning throat
  • Dry or peeling lips
  • Change in taste or smell
  • Increased dental decay
  • Joint pain

There is no single test to confirm the diagnosis of Sjogren’s syndrome. Rheumatologists primarily diagnose and manage the condition through a series of tests, including:

  • Schirmer Test to measure tear production
  • Blood tests like ANA (antinuclear antibody)
  • Small biopsy from the lower lip to examine moisture-producing glands

These tests help identify the presence and extent of the disease.


 

Early detection of Sjögren's syndrome helps manage symptoms, prevent complications, and improve quality of life. Timely diagnosis enables personalized treatment plans, reducing the risk of severe organ damage and other associated autoimmune disorders. Early intervention is crucial for better long-term outcomes in rheumatology care.

Dry eyes and dry mouth are significant nuisances for patients with Sjogren’s syndrome. Simple treatments include:

  • Tear substitutes
  • Frequent sips of water

For severe dryness:

  • Drugs like Pilocarpine and Cevimeline increase secretion

For joint pain and other manifestations:

  • Medications like Methotrexate and Rituximab may be helpful.

The prognosis for Sjogren’s syndrome varies. Many patients manage symptoms effectively with treatment, leading to a good quality of life. However, some may experience complications such as dental issues, lung or kidney problems, or increased risk of lymphoma. Early diagnosis and comprehensive care from a rheumatologist can help mitigate these risks and improve long-term outcomes.

Scoring for Sjogren’s syndrome helps assess disease activity and severity. Commonly used tools include:

  • EULAR Sjogren's Syndrome Patient Reported Index (ESSPRI): Measures patient-reported symptoms like dryness, pain, and fatigue.
  • EULAR Sjogren's Syndrome Disease Activity Index (ESSDAI): Assesses systemic disease activity across various organ systems.
  • Sicca Symptoms Inventory: Evaluates dryness symptoms in eyes and mouth.

These scoring systems aid in monitoring disease progression and guiding treatment decisions.