Sjögren’s syndrome is a systemic inflammatory disease, or in other terms, it is an autoimmune disease. It primarily causes dry eyes and dry mouth. It is mainly causing reduced tear and saliva production. The cause of the disease is the same as other autoimmune diseases. Sjögren’s syndrome is relatively uncommon, affecting nearly one in 100 people. It’s developing slowly, and symptoms may appear over several years. It happens primarily in women over 40 years of age.
In some cases, Sjögren’s syndrome is a mild but awkward disease. Usually, it doesn’t affect organs other than the eye and mouth. In Sjögren’s syndrome, the various salivary and mucus-producing glands sustain permanent damage by the attack of the immune system. Prolonged glandular inflammation reduces saliva and mucus production, which causes the organ to become dry.
Typical symptoms include:
- itchy eyes,
- dry mouth,
- decreased taste
- difficulty in swallowing.
Symptoms in head and neck
Inflammation of the salivary glands can be accompanied by swelling and pain. And in the case of the parotid gland, it goes down with swelling from the cheeks to the front of the ear.
The loss of the disinfectant effect of the too little saliva may lead to more frequent infections, the tongue may be red, cracked, the gums may wither, and tooth decay is more pronounced.
Inflammation of the mucous glands in the respiratory tract can cause hoarseness, dry nose, and dry cough.
The loss of the function of mucous glands in the skin can cause dry skin. In addition to the mucus-producing glands, the joints may also become inflamed: the small joints of the hand (fingers, wrists) may swell symmetrically and become painful. Fortunately, this does not usually lead to permanent deformities, such as rheumatoid arthritis.
In women, the dry vagina can make sex unpleasant. The patient may complain of persistent fatigue or fever. Also, the common symptom, tiredness, and weakness can often make a patient’s life more difficult.
If left untreated, the disease can cause complete atrophy of the salivary glands.
In rare cases, complications such as nervous system symptoms may occur
- spinal cord inflammation
- abnormalities reminiscent of multiple sclerosis
- numbness and tingling sensation in the legs
Rarely, the kidneys, lungs, and small blood vessels can also be affected.
Sometimes other disorders accompany Sjögren’s syndrome: autoimmune thyroiditis (Hashimoto’s disease), autoimmune liver inflammation, rheumatoid arthritis, and systemic lupus (SLE).
Patients with Sjögren’s syndrome are more likely to develop lymphoma (NHL).
Early diagnosis and treatment are important for preventing complications. Unfortunately, reaching a diagnosis can often be difficult and has been found to take an average of 2.8 years from the onset of symptoms.
Sjögren’s symptoms are frequently similar to other diseases such as lupus, rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome, and multiple sclerosis. Symptoms of dryness also can occur for reasons other than Sjögren’s, such as a side effect of medications (antidepressants, allergy, and high blood pressure medications), further making diagnosis difficult.
There is no single test that will confirm the disease, and someone does not have to test positive for all tests related to the disease to be diagnosed with Sjögren’s. However, the more tests that are positive, the easier and faster the diagnosis.
Sjögren’s syndrome treatment
Currently, Sjögren’s syndrome is not curable but controllable. With the right medicines, long-term immunosuppressant drugs (f.e.: Rituxan) can help prevent the condition from worsening and relieve the unpleasant symptoms of dry eye and mouth.
Symptomatic treatment is available for dry eye and mouth. In the case of a dry eye, it is recommended to use artificial tears several times a day. Artificial saliva is available at the pharmacy to increase saliva production, but most patients do not like it. Also, there are some new products that include mouth moisturizers, gels, sprays and specialized mouthwashes. It is advisable to drink water frequently, avoid alcoholic beverages, acidic fruits, and juices, hot and spicy foods, and smoking, which dry the mucous membrane. You can increase saliva production with chewing gum.
Reference: Sjögren’s Syndrome Foundation https://www.sjogrens.org/home/about-sjogrens