What is Sjogren’s syndrome? What are the findings and treatment methods?

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What is Sjogren’s syndrome? What are the findings and treatment methods?

Sjögren’s Syndrome is an autoimmune (self-made) disease that causes dry eyes and dry mouth. In autoimmune diseases, the body’s defense system functions against itself. The immune system is the body’s natural defense against antigens (foreign substances such as bacteria and viruses). Sometimes the immune system does not work properly and loses the ability to distinguish between its own body cells and antigens. Instead of fighting against antigens, the immune system mistakenly fights against its own body cells. This event is considered an autoimmune event.

Sjögren can occur in two forms: primary and secondary. Primary Sjögren’s Syndrome occurs on its own and is not related to other diseases.

It occurs with some types of inflammatory rheumatic diseases such as Secondary Sjögren’s Syndrome, Rheumatoid Arthritis, Lupus, Polymyositis.

Sjogren’s Syndrome; It can affect people of all ages and races, although it is relatively rare in people under the age of 20. 90% of the patients are women. The tendency to develop Sjögren’s Syndrome increases if someone in the family has the disease.

What happens in Sjogren’s syndrome?

In Sjögren’s Syndrome, a white blood cell called lymphocyte invades glands such as tear and salivary glands and glands in the vagina. Lymphocytes can damage these glands and prevent them from producing secretions. As a result, there is dryness in the mouth, eyes and vagina. Sjögren’s Syndrome can also cause problems in other parts of the body. It can cause inflammation in the lungs, kidneys, liver, nerves, thyroid gland, joints and brain.

What are their findings?

Sjögren’s Syndrome affects everyone differently and its symptoms are of varying severity. Common findings are listed below.

dry mouth

The mouth normally contains saliva and aids in chewing and swallowing. Patients with Sjögren’s Syndrome produce less saliva than normal. This makes it difficult to chew, swallow, and speak. This can also reduce the sense of taste.

dry eyes

Eyes feel dry, sandy. There may be burning and redness in the eyes. Excess mucus (burr) may accumulate around the eyes while you sleep. Your eyes may be more sensitive to sunlight. If not treated well, Sjögren’s Syndrome can lead to blind spots in the eyes and corneal ulcers (a sore on the outer part of the eyeball). Rarely, this can lead to vision loss.

swollen salivary glands

Three pairs of large glands produce saliva. They are located under the tongue, in front of the ears, under the cheek, and behind the mouth. These glands can be seen or felt as swollen. It can be confused with mumps. Sometimes it may become tender and accompanied by fever. Swollen glands occur in about half of patients with Sjögren’s Syndrome.

dental caries

This is a common problem caused by dry mouth. Saliva contains bactericidal substances (enzymes) and these substances fight bacteria. Thus, it acts as a protector against tooth decay. When saliva is reduced, fewer enzymes are produced. Therefore, easier cavities occur on the teeth.

Fungal infection in the mouth

Most people with dry mouth have burning and redness in the mouth. This complaint is caused by a fungus called Candida, which is found in small amounts in the mouth.

Dry nose, throat and lungs

Dryness; causes the throat to have a dry and tickling sensation. It can cause dry cough, hoarseness, decreased sense of smell and nosebleeds. Dryness can also lead to pneumonia, bronchitis and ear problems.

dryness of the vagina

Sjögren’s Syndrome can cause pain and irritation in the vagina due to dryness. It causes sexual intercourse to become painful for the woman.

Tiredness

It is a common finding of Sjögren’s Syndrome. It may occur due to the disease itself, or it may develop as a result of the physical and emotional stress of having a chronic disease.

Other issues

Other problems related to Sjogren’s Syndrome; inflamed and painful joints, muscle weakness, dry skin, rashes, constipation, numbness due to nerve inflammation, tingling and swollen lymph nodes. These show the importance of continuing doctor follow-up.

What causes Sjogren’s syndrome?

The reason is unknown. There is evidence that genetics, viral infection, and hormones are effective.

How is the diagnosis made?

Diagnosis is based on the history of your complaints, physical examination and test results.

History of Your Complaints

Your doctor will review your history of complaints.

Physical Examination

Your doctor will look for changes in your eyes, mouth, and/or salivary glands, swelling of the lymph nodes in your neck, tenderness in your muscles, and inflammation in your joints.

Results of chest X-ray

Your doctor will order a chest X-ray to determine if there are any changes in your lungs.

lab tests

Your doctor may ask you to have various laboratory tests listed below.

blood tests

Tests for specific blood findings are helpful in diagnosing Sjögren’s Syndrome. However, not everyone with Sjögren’s has these signs, or not everyone with these signs has Sjögren’s syndrome.

Schirmer test

This test helps determine how dry your eyes are. It is performed by placing a small piece of filter paper over the lower eyelid to measure the amount of tears produced.

A note about pregnancy

A woman with Sjögren’s Syndrome may have special problems with the development of the baby in the womb. Your doctor may check certain tests (antibodies) to identify potential problems. If you are a woman with one of the rheumatological diseases related to secondary Sjögren’s syndrome – especially if you have lung and kidney problems and/or high blood pressure, be sure to see your doctor. If you become pregnant, you and your doctor will work to determine the best treatment plan.

Slit-lamp review 

This is a more accurate way to determine the dryness of your eyes. With this test, the doctor puts a drop of dye in your eye and examines your eyes with a special instrument called a slit-lamp. The dye will paint over dry or damaged areas of your eyes. This is usually done by an ophthalmologist.

Lip biopsy

These tests help measure the actual amount of saliva and determine how dry your mouth is. This is the most definitive test to make the diagnosis.

urine tests

These tests may be done to check your kidney function.

How is Sjogren’s syndrome treated?

For now, there is no definitive cure for Sjögren’s syndrome. However, certain treatments can help relieve symptoms and provide a more comfortable and productive life. One of the main goals of treatment is to increase life comfort and prevent or reduce the effects of dryness. Because Sjögren’s Syndrome affects everyone differently, the treatment plan should be tailored to specific needs. Here are some suggestions to help you deal with complaints.

For systemic problems

Because Sjögren’s Syndrome affects various internal organs and body parts, a variety of treatments can be used. NSAIDs (painkillers and anti-inflammatory drugs) can be used to relieve joint pain and stiffness, as well as muscle pain.

Recent studies have shown that Hydroxychloroquine (Quensyl, Plequanyl) helps relieve joint pain, rash and fatigue in some people. If serious tissue damage has occurred due to the disease, your doctor may prescribe cortisone (prednol, deltacortril, ultralan, flantadine) or stronger drugs that alter or modulate the immune system’s response (immunosuppressive).

Exercise can help by keeping your joints and muscles flexible. Walking, swimming and exercises that increase joint movement are very suitable for people with Sjögren’s syndrome.

for dry mouth 

  • Sip water throughout the day
  • Use sugar-free gum to stimulate saliva production
  • brush your teeth often
  • Go for treatment for oral fungal infections. Your mouth will be better from now on. Candidiasis is a recurring condition, so you may need additional treatments
  • Try artificial saliva or mouth-protective gels. Partially useful at night

To prevent bruises

  • Visit your dentist often
  • Ask your dentist to recommend products containing fluoride, especially for dry mouth
  • Brush your teeth regularly and effectively, especially after meals
  • Do not use sugary foods and drinks between meals

for dry eyes

  • Use artificial tears to relieve discomfort from dry eyes. If you are going to apply more than 4 drops a day, you can use products without preservatives.
  • Use lubricating eye ointments at night
  • Your doctor may recommend a simple operation to prevent tears from flowing from your eyes and into your nose. This operation allows tears to accumulate in your eyes and your eyes benefit from natural moisture.

for dry skin

  • Use moisturizing lotion for sensitive skin
  • Stay away from air conditioners, heaters and radiators as much as possible.
  • Avoid detergents, deodorant soaps and very hot water
  • Use as much moisturizer as possible.

For vaginal dryness

Use creams made specifically for vaginal dryness