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Sjögren’s Syndrome

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Overview

Sjögren’s Syndrome is a chronic autoimmune disorder that primarily affects the body’s moisture-producing glands, leading to dry mouth, dry eyes, and other systemic complications. It can occur on its own (primary Sjögren’s) or in conjunction with other autoimmune diseases like rheumatoid arthritis or lupus (secondary Sjögren’s). Our comprehensive Sjögren’s Syndrome services focus on early diagnosis, symptom relief, and ongoing management to improve quality of life and prevent complications.

Diagnostic Procedures

  1. Clinical Evaluation:
    • A detailed medical history and physical exam, with a focus on common symptoms such as dry eyes and dry mouth (xerostomia), as well as joint pain and swelling.
  2. Laboratory Tests:
    • Antinuclear Antibody (ANA) Test: Common in autoimmune diseases, a positive ANA is often seen in Sjögren’s Syndrome.
    • Anti-Ro/SSA and Anti-La/SSB Antibodies: Specific tests to detect antibodies typically present in patients with Sjögren’s.
    • Rheumatoid Factor (RF): Often elevated in Sjögren’s patients, particularly those with secondary Sjögren’s linked to rheumatoid arthritis.
    • Erythrocyte Sedimentation Rate (ESR): To check for systemic inflammation.
  3. Schirmer’s Test:
    • A simple test to measure tear production by placing small strips of paper under the lower eyelid. Low tear production is a key indicator of Sjögren’s.
  4. Salivary Gland Biopsy (Lip Biopsy):
    • A small tissue sample is taken from the salivary glands in the lip to detect the presence of lymphocytes, indicating inflammation and confirming the diagnosis of Sjögren’s.
  5. Sialography or Salivary Scintigraphy:
    • Imaging studies used to evaluate the salivary glands and assess their function.
  6. Ocular Staining Test:
    • Special dyes are used to detect damage to the surface of the eyes caused by dryness.

Symptoms of Sjögren’s Syndrome

  • Dry Eyes (Keratoconjunctivitis Sicca): A gritty, burning sensation in the eyes, with sensitivity to light and redness.
  • Dry Mouth (Xerostomia): Difficulty swallowing, talking, or tasting food due to a lack of saliva. Patients may also experience frequent dental cavities and oral infections.
  • Swollen Salivary Glands: Particularly the glands in the cheeks and under the jaw.
  • Fatigue: Persistent tiredness, even with adequate sleep.
  • Joint Pain and Stiffness: Arthritis-like symptoms, often involving the hands, wrists, and knees.
  • Dry Skin: Scaling, itchiness, and general discomfort.
  • Vaginal Dryness: Leading to discomfort or pain during intercourse.
  • Other Complications: May include lung issues, kidney problems, or vasculitis in more severe cases.

Possible Treatments

  1. Medications:
    • Artificial Tears and Lubricating Eye Drops: To relieve dry eye symptoms.
    • Saliva Substitutes and Stimulants: Pilocarpine or cevimeline may be prescribed to stimulate saliva production.
    • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): For joint pain and inflammation.
    • Hydroxychloroquine (Plaquenil): An antimalarial drug often used to treat autoimmune conditions, particularly if Sjögren’s is linked to lupus or rheumatoid arthritis.
    • Corticosteroids: To manage inflammation in more severe cases.
    • Immunosuppressive Agents: Such as methotrexate or biologics to control the autoimmune response in more systemic cases.
    • Antifungal Medications: To treat oral thrush, which can occur due to dry mouth.
  2. Moisture Retention Strategies:
    • Humidifiers: Use of a humidifier at home to keep the air moist and relieve dry eyes and mouth.
    • Hydration: Regularly drinking water to stay hydrated and combat dry mouth.
  3. Lifestyle Modifications:
    • Oral Hygiene: Regular dental check-ups, the use of fluoride toothpaste, and specialized mouth rinses to protect teeth from decay and oral infections.
    • Dietary Adjustments: Avoiding caffeine, alcohol, and spicy foods that can exacerbate dry mouth.
    • Eyewear Protection: Wearing wraparound glasses to protect the eyes from wind and dry air.
  4. Physical Therapy:
    • For managing joint pain and improving mobility in cases of arthritis-related symptoms.
  5. Specialized Care for Complications:
    • Lung or Kidney Involvement: For patients with organ involvement, specialized treatments including corticosteroids or immunosuppressants may be necessary.

Final Results

With appropriate treatment and management, patients with Sjögren’s Syndrome can achieve:

  • Symptom Relief: Reduced dry eyes, dry mouth, and joint pain, allowing patients to lead more comfortable daily lives.
  • Prevention of Complications: Protection of the eyes, mouth, and other organs from long-term damage.
  • Improved Quality of Life: Tailored management plans ensure patients can continue to work, socialize, and live actively without debilitating symptoms.
  • Systemic Control: Through immunosuppressive treatments, preventing the progression of the disease and reducing the risk of severe organ involvement.

Our multidisciplinary team of rheumatologists, ophthalmologists, and dental specialists work together to deliver personalized care for Sjögren’s Syndrome, addressing both symptoms and underlying autoimmune processes to ensure the best long-term outcomes for our patients.

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