- Sjögren's syndrome (dryness syndrome): causes
- Sjögren's syndrome (dryness syndrome): symptoms
- Sjögren's syndrome: research
- Sjögren's syndrome (dryness syndrome): treatment
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Sjögren's syndrome, or dryness syndrome, is an autoimmune disease that leads to the impairment of e.g. the lacrimal glands and salivary glands. Interestingly, it mainly affects menopausal women. What are its causes and symptoms? What is the treatment of Sjögren's syndrome?
Sjögren's syndrome,otherwisedryness syndromeor Mikulicz-Radecki disease, is a chronic autoimmune disease in which inflammation occurs in the within the external secretion glands, and thus - to their impairment. Often, inflammatory lesions also affect many internal organs (mainly lungs, kidneys, gastrointestinal organs, thyroid gland).
Sjögren's syndrome is the second most common autoimmune disease after rheumatoid arthritis. It is estimated that from 0.5 to 5% of the population struggle with it, of which over 90% of patients are women (especially between 45 and 55 years of age).
Sjögren's syndrome (dryness syndrome): causes
Sjögren's syndromeis an autoimmune disease, which means that the body's immune system attacks and destroys its own cells for unknown reasons. In this disease, white blood cells (lymphocytes) attack the endocrine glands, leading to inflammation, impairment and, consequently, to disruption of tear or saliva production.
The reasons for this state are the following factors:
- genetic
- immunological (carrier of a certain group of histocompatibility antigens, such as: HLA-B8, DR2, DR3, DQ)
- infectious (Epstein-Barr virus, cytomegalovirus, hepatitis C, HIV)
Due to the fact that dryness syndrome is most common in perimenopausal women, it is believed that hormonal changes may also be the cause of the disease.
Sjögren's syndrome (dryness syndrome): symptoms
The symptoms of Sjögren's syndromeare divided into two groups: symptoms related to the involvement of the external secretion glands and extra-glandular symptoms related to the involvement of internal organs.
The first group includes symptoms of lacrimal gland dysfunction:
- xerophthalmia, i.e. dryness of the cornea and conjunctiva felt as "sand" under the eyelids
- burning and scratching sensation in the eyes
- conjunctival redness
- eye hypersensitivity to light and cigarette smoke
- xerostomia, i.e. dry mouth and the associated difficulties in chewing and swallowing food
Symptoms of dysfunction of the salivary glands:
- dry mouth
- problems with chewing and swallowing food
- speech problems
- loss or disturbance of taste and smell
- rapidly progressing tooth decay
- fungal infection of the oral cavity
- deepening furrows on the tongue and lips
These disorders may result in dry nose and throat leading to sinusitis, bronchitis, or pneumonia. In addition, women may experience vaginal dryness, which causes burning and discomfort during intercourse.
The so-called Raynaud's phenomenon - blueness of the hands combined with pain in the fingers (intensified by low temperature and emotions).
Extra-glandular symptoms are joint complaints similar to rheumatoid arthritis, enlarged lymph nodes, changes in the lungs, kidneys, pancreatitis or thyroiditis.
Sjögren's syndrome: research
Early diagnosis of dryness syndrome is made possible by laboratory tests such as blood counts and ANA testing (anti-Ro and anti-La). Patients have elevated levels of gamma globulin, anemia and leukopenia.
The severity of the dryness symptom is usually checked with the Schirmer's test, which assesses the amount of tears produced.
The Saxon test is also helpful, i.e. measuring the amount of saliva produced (in the patient this amount is significantly reduced) and sialography (examination of the salivary ducts with contrast).
Pregnant women diagnosed with Sjögren's syndrome require specialist care. It is then necessary to monitor the fetal heart. This is because the antibodies can cross the placenta and trigger a congenital heart block in the baby.
The saliva and tear crystallization test can also be performed - in Sjögren's syndrome, the crystallization is abnormal due to the altered composition of saliva and tears.
Imaging tests, such as radioisotope scintigraphy and salivary gland ultrasound, are also performed.
In diagnostics, microscopic examination (biopsy of the mucous gland) and staining of the cornea with rose bengal may be necessary, which makes it possible to distinguish Sjögren's syndrome from other diseases associated with dry eyes.
Sjögren's syndrome (dryness syndrome): treatment
In treatment, attention is focused on the protection of the eyes, including throughuse of the so-called artificial tears consisting of methyl cellulose or polyvinyl alcohol. Sometimes I use pilocarpine, chloroquine and sometimes glucocorticosteroids or other immunosuppressive drugs.
The doctor who treats the disease is a rheumatologist.
About the author
Monika Majewska A journalist specializing in he alth issues, especially in the areas of medicine, he alth protection and he althy eating. Author of news, guides, interviews with experts and reports. Participant of the largest Polish National Medical Conference "Polish woman in Europe", organized by the "Journalists for He alth" Association, as well as specialist workshops and seminars for journalists organized by the Association.
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