Sjogren’s Syndrome

Sjögren’s Syndrome is an autoimmune disease in which the immune system become over active and produces antibodies that target normal healthy tissue, resulting in damage. In Sjögren’s syndrome, inflammation is targeted at the Exocrine glands, which produce substances such as saliva, tears, sweat and digestive juices. The main symptoms of Sjogrens syndrome are dry eyes and dry mouth.

There are two classifications of Sjögren’s syndrome; Primary Sjögren’s syndrome, which occurs on its own and secondary Sjögren’s syndrome which occurs along with another rheumatic disease such as Rheumatoid Arthritis or Systemic Lupus Erythematosus (SLE).

Sjögren’s syndrome most commonly affects people between aged between 40-60 years and is more common in females. The exact cause of Sjögren’s syndrome is unknown, but there is evidence of genetic and environmental factors.

Most common symptoms include:

  • Dry, sore, gritty eyes
    • Strong lights may feel uncomfortable, or the eyes become sticky with mucus
  • Dry mouth and/or throat
    • This can cause difficulty chewing or swallowing food- or lead to mouth ulcers or altered taste.
    • Occasionally, a very dry mouth can lead to other problems such as fungal infections.
    • The salivary glands may also become painful and/or swollen.
  • Fatigue
    • Un-refreshed following sleep. Some people may also feel down or depressed.

There may also be dryness of the skin, vagina or breathing tubes.

Rarely Sjögren’s syndrome can be associated with developing other conditions such as:

  • Joint pain or stiffness
    • Some joints may also be swollen. Joint problems are usually less severe than in RA
  • Skin changes
    • Rarely vasculitis
  • Raynaud’s phenomenon- finger or toes turning pale, then blue in the cold
  • Nerve problems
    • Reduced sensation in the nerves of the hands and feet
  • Underactive thyroid
  • Lung problems
  • Kidney and liver problems
  • Problems with your blood
    • Anaemia
    • Lymphoma- cancer of the white blood cells. This can cause enlarged lymph glands in your neck, armpit and groins as well as fevers and night sweats.

A history of relevant symptoms will be the most important way that the doctor suspects the diagnosis. This will be confirmed by relevant tests that includes:

  • Schirmer’s test
    • Tests for tear production-a sterile strip of paper is placed under the lower eyelid for 5 minutes
  • Formal eye examinations for tear production can be carried out at your opticians
  • Saliva production
    • you will be asked to spit into a pot for 5 minutes and the volume of saliva will be measured.
  • An ultrasound of the salivary glands may show if there are areas of damage or immune cell accumulation within the tissues
  • Specific blood tests
  • Minor salivary gland biopsy. This test is reserved for cases that are not diagnosed based on the above tests, but where the doctor still suspects the diagnosis of Sjögren’s Syndrome.

Our CTD Nurse is able to provide education and advice on self-management for sicca symptoms (dryness) and discuss and recommend treatments that may help.

 

Published: 13/10/2022 14:53