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Sjogren's syndrome

Sjögren's syndrome is an autoimmune disorder, that is, your immune system attacks your own body’s cells and tissues. 

A man placing eyedrops in dry eyes

While its causes are not clear, there may be a genetic link that places certain individuals at higher risk. It is also believed that a triggering mechanism, for instance an infection from a particular virus or bacteria, is necessary to precipitate the disease. 

With Sjögren's, white blood cells target healthy cells in the glands that make saliva and tears. The disorder may occur in conjunction with other immune disorders such as lupus and rheumatoid arthritis

Sjögren's syndrome can also affect other parts of the body, such as the joints, thyroid, skin and nerves, and less commonly the lungs, liver and kidneys. 

What are its symptoms?

In Sjögren's syndrome the main symptoms include the following:

  • Dry eyes that may burn, itch and feel gritty
  • Dry mouth that makes talking and swallowing difficult; and may lead to yeast infections
  • Increased risk of dental cavities and gum disease (as saliva helps protect both teeth and gums)

Additional symptoms that may develop with the disorder include:

  • Rash and dry skin
  • Swelling, stiffness and pain in the joints 
  • Swollen saliva gland
  • Vaginal dryness
  • Dry cough that is persistent
  • Fatigue

How is it diagnosed? 

Sjögren's mimics the symptoms of other illnesses and the side effects of some medications, so diagnosis may be tricky. A number of tests may help to rule out other conditions, including:

  • Blood tests: This will help detect the presence of antibodies associated with Sjögren's, provide evidence of inflammatory conditions, and ascertain whether there are any liver or kidney problems. 
  • Eye test: This involves a tear test that measures tear production, as well as a test to examine the surface of the eye with a special magnifying device called a slit lamp.
  • Imaging tests: The functioning of the salivary glands can be checked in this way, as well as with a special X-ray called a sialogram – in this procedure dye is injected into the salivary glands to show how much saliva is flowing into your mouth. 

What are your treatment options? 

Treatment involves managing and relieving symptoms with medicine, including the use of certain over-the-counter medications. This includes:

  • Artificial tears (eye drops) used regularly throughout, and eye gels used at night can alleviate dry eyes.
  • Certain prescription drugs that come with applicators may be recommended if over-the-counter meds aren’t helping enough. These can be applied less often during the day.
  • Certain drugs can increase the production of saliva. Discuss the side effects of these meds with your doctor. Sucking sour sweets can also help to stimulate saliva production. 
  • For joint pain and arthritis symptoms, nonsteroidal anti-inflammatories may be beneficial.
  • In some cases, the antimalarial drug hydroxychloroquine, has been known to be helpful, as well as immune suppressants, which may be prescribed.

Can it be prevented? 

There are no clearly defined preventative measures for Sjögren's; however it appears to be more prevalent in individuals with one or more of the following risk factors:

  • People over 40 years of age
  • Women are more likely to develop it
  • It appears to be more common in people who have rheumatic disease, that is, arthritis or lupus.

Taking steps to manage symptoms and medical check-ups to prevent complications is advised.

IMAGE CREDIT: 123rf.com

The accuracy of this information was checked and approved by physician Dr Thomas Blake in July 2016