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Sjögren syndrome

Sjögren syndrome is a systemic chronic inflammatory disorder of unknown cause identified by its two most common symptoms — dry eyes and a dry mouth due to a decreased function in the lacrimal and salivary glands.

It is a slow progressing disease that can affect up to 3% of the population, the majority of which are middle-aged women, although it can appear at any age.

There are two forms of Sjögren's syndrome:

  • Secondary Sjögren's syndrome: it appears simultaneously with rheumatoid arthritis, (RA) or systemic lupus erythematosus (SLE), scleroderma or primary biliary cirrhosis.
  • Primary Sjögren's syndrome: not associated with another autoimmune illness

External secretion glands are located in the eyes (lacrimal glands), the vagina, the skin, the intestine and in the bronchials. Their progressive destruction causes a reduction of tears and saliva and vaginal, bronchial, intestinal and sweat secretions provoking the sensation of dryness that patients feel. Pain and inflammation of the joints are frequent which is why it is considered a rheumatic disease. In addition, the majority of disease it is associated with are rheumatic diseases.

Symptoms

There are no two similar symptoms of Sjögren's; some patients may experience mild discomfort, others more severe, even serious and others almost nothing. Nevertheless, the following symptoms appear in the majority of patients:

  • Dry mouth and cavities: the destruction to a greater or lesser extent of the saliva glands causes the loss of saliva. The patient has the sensation of dry mouth and difficulty swallowing. He/she needs to drink more water during meals and notes a diminished sense of taste. Saliva is important for healthy teeth and the lack of it causes hygiene to be deficient, causing cavities.
  • Dry eyes: Inflammation of the lacrimal glands reduces tear production. Patients experience the sensation of sandy or gritty eyes, stringy discharge from the eye and frequently, reddened eyes. The eyes become more light-sensitive to the point that they cannot tolerate sunlight. Patients with severe Sjögren's syndrome risk painful ulcers on the cornea.
  • Arthritis, fatigue and other dymptoms: Patients can have joint pain, generally in the hands and occasionally inflammation. Fatigue is a frequent symptom as with other rheumatic diseases. In women, the malfunction of the glands in the vagina cause dryness in the vagina and Sjögren's patients experience pain during sexual relations.
  • Other parts of the body can also be affected, including the intestines, bronchial tubes, lungs, thyroids, skin, muscles, kidneys or the nervous system. Some patients experience constipation due to intestinal dryness or frequent colds due to the lack of bronchial secretions. Other symptoms can appear with less frequency and their link to Sjögren's syndrome should be evaluated by a rheumatologist.

Prevention

Ocular symptoms can improve with measures taken to maintain the eye's moisture, such as:

  • Use of artificial tears several times a day and humidifiers in the home
  • On getting up in the morning, bathing the eyes with a damp cloth for several minutes
  • To avoid nighttime dryness, use ocular ointments
  • Patients who are sunlight sensitive should use sunglasses; when swimming, use appropriate swim goggles
  • Have periodic check-ups by the ophthalmologist

Dry mouth symptoms can be relieved by:

  • Using artificial saliva, drinking water frequently (mixed with a few drops of lemon)
  • Chewing gum or sweets, sugarless, and pilocarpine use can be helpful to stimulate saliva production
  • Oral hygiene is indispensible to prevent cavities and infections. Brushing teeth three times a day, using special toothpastes for dry mouth, rinsing with fluoride-enriched mouthwash or elixir is recommended. Avoid foods or drinks with a high sugar content
  • Dental check-ups every 6 months.

 

Vaginal dryness improves with the use of lubricants. Visit a gynecologist periodically.

Gene or region studied

  • 7q32.1
  • STAT4
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