Sjogren's Syndrome: Causes, Risk Factors, Signs, Symptoms, Investigations, Treatment
Sjogren's syndrome is an autoimmune disorder consisting of dry mouth and dry eyes, as its primary symptoms. Sjogren's syndrome is often seen with other immune-system disorders, like lupus and rheumatoid arthritis. In this condition, the mucous membranes and the glands which secrete moisture in the mouth and eyes are the first ones to be affected resulting in decreased production of saliva and tears. Individuals greater than 40 years of age are found to develop this condition more than others; however, people from any age group can suffer from Sjogren's syndrome. Women more commonly are affected by this condition. The aim of treatment is alleviating the symptoms. The symptoms gradually subside over a period of time.
Causes of Sjogren's Syndrome
Sjogren's syndrome is a disorder of the immune system where our body's immune system wrongly attacks its own tissues and cells in the body. The exact cause of why this happens is not clear. There are certain risk factors, such as individuals with specific genes are at an increased risk for developing this disorder. Other triggering conditions, such as exposure to infection with a specific strain of bacteria or virus, also cause this condition.
As mentioned previously, the immune system first attacks the glands which are responsible for secreting moisture in the mouth and eyes. There are also other body parts which are affected, such as nerves, thyroid, skin, joints, kidneys, lungs and liver.
Risk Factors for Sjogren's Syndrome
- Individuals over the age of 40 are at an increased risk for developing this syndrome.
- Women are more prone to developing Sjogren's syndrome.
- Individuals who already suffer from other immune system disorders, such as lupus or rheumatic disease, are at an increased risk for developing this syndrome.
Signs and Symptoms of Sjogren's Syndrome
The Two Chief Symptoms Are:
- Dryness of the eyes leading to burning, itching or grittiness in the eyes.
- Dryness of the mouth, so that the mouth feels like it is stuffed with cotton resulting in difficulty with speaking and in swallowing.
Other Symptoms Are:
- Pain, stiffness and swelling of the joints.
- Swelling of the salivary glands.
- Skin dryness or rashes.
- Vaginal dryness.
- Prolonged dry cough.
- Persistent fatigue.
Investigations for Sjogren's Syndrome
It is difficult to diagnose Sjogren's syndrome, as symptoms differ from patient to patient and also can resemble those symptoms caused by other medical conditions. There are many medications which produce side effects resembling symptoms of Sjogren's syndrome.
Tests Done For Ruling Out Other Medical Conditions And Arriving At A Proper Diagnosis Of Sjogren's Syndrome Include:
- Blood tests helps in finding the levels of different blood cells types, antibodies, level of blood glucose, other indications of inflammatory conditions and any signs of problem with kidneys and liver.
- Eye tests, such as Schirmer's test, are done to measure the dryness of the eyes and slit-lamp test is done to examine the eye's surface.
Imaging Tests for Sjogren's Syndrome:
- Sialography is done to check the salivary glands' condition and to assess the amount of saliva which flows into the mouth.
- Salivary scintigraphy is a nuclear medicine testing done by injecting radioactive isotope. This is traced to measure and assess the function of the salivary glands.
- Chest x-ray is done to look at the lungs, as Sjogren's syndrome may also cause inflammation of the lungs.
Other Tests For Sjogren's Syndrome
- Biopsy of the lips is done to look for a group of inflammatory cells indicating Sjogren's syndrome.
- Spit test helps in measuring the saliva and the severity of the dryness of the mouth.
- Urine sample to find out if the kidneys are affected by the Sjogren's syndrome.
Treatment for Sjogren's syndrome
Treatment comprises of managing symptoms, such as using OTC eye drops and drinking lots of water to combat eye and mouth dryness. Sometimes surgery may also be needed. Other than this, medications used are:
- Medicines, such as pilocarpine and cevimeline, help in increasing saliva production and occasionally tears. Side effects are: Flushing, sweating, pain in the abdomen and increased urination.
- NSAIDs or arthritis medicines are used if the patient develops additional arthritis symptoms.
- Antifungal medications are given for oral yeast infections.
- Anti-malarial drugs, such as hydroxychloroquine is also beneficial in Sjogren's syndrome.
- Immunosuppressants, such as cyclosporine or methotrexate, are also used for this syndrome.
- Surgery is done to relieve dryness of the eyes where the tear ducts are sealed. Sometimes laser is also used for sealing the tear ducts.