SJOGREN’S SYNDROME (SS):  is one of over eighty autoimmune disorders and is classified as a connective tissue disorder that targets the exocrine system, specifically the lacrimal (production/drainage of tears) and salivary glands.

FACTS:

• It is a chronic inflammatory disorder
• It is characterized as 1⁰ (if there are only symptoms of SS) or 2⁰ (if SS is associated with other autoimmune connective tissue disorders such as SLE, RA, etc.)
• 50% of people are diagnosed as primary Sjogren’s
• The cause is unknown
• It is more common in women
• It can present at any age, but usually seen over the age of 40

 

CLASSIC EXOCRINE GLANDS SYMPTOMS:

• Sicca Complex: xerophthalmia (dry eyes) and xerostomia (dry mouth)
• Variable conjunctival injection (redness)
• Reduced visual acuity
• Sensitivity to light
• Keratitis (inflammation of the cornea) and corneal erosions
• Dryness of other mucosal membranes

 

OTHER SYMPTOMS THAT MAY BE PRESENT:

• Joint pain and swelling
• Prolonged fatigue
• Skin rashes and dry skin
• Persistent dry cough, bronchitis, dyspnea
• Epistaxis (nose bleed)
• Dysphonia
• Otitis media (middle ear infection)
• Dysphagia
• Constipation

 

SYMPTOMS THAT MAY COMPLICATE THE COURSE OF SS:

• Involvement of the kidneys
• Peripheral and cranial neuropathy
• Systemic lymphadenopathy

 

DIAGNOSIS: may be a drawn out process and is based on patient history of symptoms, physical examination and various test results.

• Ophthalmologic exam: the Schirmer’s filter paper test is used to assess the degree of dryness of the eyes and examination of the eye to check for corneal erosions and keratitis
• Assessment of pathology and function of the salivary glands: biopsy (to determine degree of inflammation utilizing the “focus score”), sialogram and salivary scintigraphy
• Blood work: checking for autoantibodies (SS-A antibodies are found in 50-75% of people with SS and SS-B antibodies are found in 50-60% of people with SS)

 

TREATMENT: there is no known cure; therefore, treatment is aimed at alleviating the symptoms and complications of the sicca (dryness) complex.

• Antibiotics for infections
• Water soluble lubricants and moisturizing eye drops
• Drugs to increase the production of saliva
• Surgical intervention
• Corticosteroids
• Immunosuppressive agents

 

PROGNOSIS: symptoms of Sjogren’s Syndrome may stabilize, worsen or go into remission.

 

 

ANTIBODY (aka: immunoglobulin): is a protein that is produced by plasma cells of the body’s defense system (aka: the immune system) to detect and neutralize foreign objects that are deemed as harmful to the body.

AUTOIMMUNE: our immune system erroneously starts attacking and destroying healthy body tissue.

FOCUS SCORE: equal or greater than 1 is compatible with Sjogren’s Syndrome

RA: Rheumatoid arthritis

SLE: Systemic Lupus Erythematosus (commonly called Lupus)

SS-A (Ro) antibodies

SS-B (La) antibodies