Sjogren’s Syndrome

SJOGREN’S SYNDROME (SS):  is one of over eighty autoimmune disorders and is classified as a connective tissue disorder that targets the exocrine system, specifically the lacrimal (production/drainage of tears) and salivary glands.

FACTS:

  • It is a chronic inflammatory disorder
  • It is characterized as 1⁰ (if there are only symptoms of SS) or 2⁰ (if SS is associated with other autoimmune connective tissue disorders such as SLE, RA, etc.)
  • 50% of people are diagnosed as primary Sjogren’s
  • The cause is unknown
  • It is more common in women
  • It can present at any age, but usually seen over the age of 40

 

CLASSIC EXOCRINE GLANDS SYMPTOMS:

  • Sicca Complex: xerophthalmia (dry eyes) and xerostomia (dry mouth)
  • Variable conjunctival injection (redness)
  • Reduced visual acuity
  • Sensitivity to light
  • Keratitis (inflammation of the cornea) and corneal erosions
  • Dryness of other mucosal membranes

 

OTHER SYMPTOMS THAT MAY BE PRESENT:

    • Joint pain and swelling
    • Prolonged fatigue
    • Skin rashes and dry skin
    • Persistent dry cough, bronchitis, dyspnea
    • Epistaxis (nose bleed)
    • Dysphonia
    • Otitis media (middle ear infection)
    • Dysphagia
    • Constipation

 

SYMPTOMS THAT MAY COMPLICATE THE COURSE OF SS:

  • Involvement of the kidneys
  • Peripheral and cranial neuropathy
  • Systemic lymphadenopathy

 

DIAGNOSIS: may be a drawn out process and is based on patient history of symptoms, physical examination and various test results.

  • Ophthalmologic exam: the Schirmer’s filter paper test is used to assess the degree of dryness of the eyes and examination of the eye to check for corneal erosions and keratitis
  • Assessment of pathology and function of the salivary glands: biopsy (to determine degree of inflammation utilizing the “focus score”), sialogram and salivary scintigraphy
  • Blood work: checking for autoantibodies (SS-A antibodies are found in 50-75% of people with SS and SS-B antibodies are found in 50-60% of people with SS)

 

TREATMENT: there is no known cure; therefore, treatment is aimed at alleviating the symptoms and complications of the sicca (dryness) complex.

  • Antibiotics for infections
  • Water soluble lubricants and moisturizing eye drops
  • Drugs to increase the production of saliva
  • Surgical intervention
  • Corticosteroids
  • Immunosuppressive agents

 

PROGNOSIS: symptoms of Sjogren’s Syndrome may stabilize, worsen or go into remission.

 

 

ANTIBODY (aka: immunoglobulin): is a protein that is produced by plasma cells of the body’s defense system (aka: the immune system) to detect and neutralize foreign objects that are deemed as harmful to the body.

AUTOIMMUNE: our immune system erroneously starts attacking and destroying healthy body tissue.

FOCUS SCORE: equal or greater than 1 is compatible with Sjogren’s Syndrome

RA: Rheumatoid arthritis

SLE: Systemic Lupus Erythematosus (commonly called Lupus)

SS-A (Ro) antibodies

SS-B (La) antibodies

1 Comment

  1. Wow..this is great medical information. I was not aware of this disease and did not know that Venus was dealing with this battle.

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