Sjögren's
Syndrome (SS) is a chronic autoimmune disease always giving rise to
hypofunction of the major exocrine glands - lacrimal and salivary glands
and to dryness of e.g. eyes, mouth, nose, throat and upper and lower
airways. In addition patients experience extreme fatigue.
Sjögren's
Syndrome is the most common (about 2 %) of the different rheumatic systeme
diseases including rheumatoid arthritis (RA), systemic lupus erythematosus
(SLE) and scleroderma. For unknown reasons, 90 % of diagnosed patients
are women. Sjögren's Syndrome can start anytime in life, but it's
most likely to start between the age of 35-55. Sjögren's Syndrome
is usually onsetting gradually.
How to
distinguish between Primary and Secondary SS:
SS may
occur as a separate disease called primary Sjögren's Syndrome.
If SS
occurs in patients who already have another well-developed and characterised
rheumatic disease (e.g. RA or SLE), it is called secondary Sjögren's
Syndrome.
Primary
SS is more common than secondary SS.
Fatigue
One of the important symptoms is severe fatigue. The
fatigue reduces the quality of life, but since the symptoms may occur
in periods, you can during longer or shorter intervals, live a life
with reasonable quality. Unfortunately these periods are always followed
by a period of fatigue.
Dry
eyes
Dry eyes is often experienced by a person having Sjögren's
Syndrome with a sense of having grit in the eyes.
The
eyes feel tired, burn and hurt when blinking. The eyes easily turn
red and smoke and windy conditions present problems. Reading often
becomes tiring, since the lack of tearfluid makes the text blur. This
has nothing to do with myopia (short-sightedness) or long-sightedness.
Contact-lenses should be avoided and the use of makeup should be reduced.
From the tear glands pains and swellings may occur. The use of artificial
tears is recommended.
Dry
mouth, nose and throat
As the salivary glands have a reduced function, problems
occur when swallowing food and clearing the mouth after a meal. In spite
of good mouth-hygiene, the SS-patient often has a high frequency of
dental caries, funghi-problems and has to visit the dentist. The dentist
is often the person who frequently gives the first diagnosis as Sjögren's
Syndrome. Then together with an eye-specialist and a rheumatologist
the final diagnosis as Sjögren's Syndrome can be established.
SS
often leads to problems with the upper and lower airways and asthmatic
symptoms are not rare. A typical SS-patient has to drink a lot of
water or soft drinks to reduce the problems.
Jointpain
Many patients experience periods of pain and sometimes
swelling of the wrist and finger joints.
Diagnosis
The diagnose is often not easy as the symptoms of
Sjögren's Syndrome can mimic other diseases. Even when the symptoms
are reported to various specialists, physicians, dentists or eye-specialists,
the diagnoses is often missed. In addition to this, people with Sjögren's
Syndrome never have exactly the same set of symptoms or medical history.
Once Sjögren's Syndrome is suspected, blood tests for unusual
proteins (auto-antibodies), tests to determine the degree of dry eyes
and dry mouth including lower lip biopsy might be indicated.
Treatment
There is at the moment no known cure for Sjögren's
Syndrome. Moisture replacement therapies, including chewing gum can
help the symptoms of dryness. Non-steroid anti-inflammatory drugs
(NSAIDs) are often used as pain killers. For individuals with severe
complications, more aggressive treatment may be necessary. Presently,
no single gene, micro-organism or hormone is known to cause Sjögren's
Syndrome. Further research is necessary from the medical and pharmaceutical
communities to find causes and new treatments for the Sjögren's
Syndrome patient.
