Sjogrens Syndrome

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Sjogrens Syndrome is a disorder of your immune system often defined by its two most common symptoms — dry eyes and a dry mouth.

Sjogren's syndrome often accompanies other autoimmune disorders — such as rheumatoid arthritis and lupus. These diseases are marked by inflammation of your connective tissues, and it's common for people with Sjogren's syndrome to also have a connective tissue disorder.

In Sjogrens syndrome, your immune system attacks healthy tissue. The mucous membranes and moisture-secreting glands of your eyes and mouth are usually affected first, resulting in decreased production of tears and saliva. The disease can damage other tissues as well.

Although you can develop Sjogrens syndrome at any age, most people are older than 40 at diagnosis. The condition is much more common in women. There's no cure, but treatments can relieve many symptoms.


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Sjogren's syndrome can be difficult to diagnose because the signs and symptoms are similar to those caused by other diseases and can vary from person to person. In addition, the side effects of a number of medications can mimic some signs and symptoms of Sjogren's syndrome. Still, typical signs and symptoms of Sjogrens syndrome include:
  • Dry eyes
  • Dry mouth
  • Dental cavities
  • Fatigue
  • Enlarged parotid glands
  • Difficulty swallowing or chewing
  • Change in sense of taste
  • Hoarseness
  • Oral yeast infections, such as candidiasis
  • Skin rashes or dry skin
  • Vaginal dryness
  • Dry cough that doesn't produce sputum
  • Joint pain, swelling and stiffness
Sjogren's syndrome is an autoimmune disorder. This means that your body attacks its own cells and tissues.

It's unknown why this happens, but researchers believe that a combination of factors causes something to go wrong with your immune system. These factors may be related to heredity, hormones, a viral or bacterial infection, or your nervous system.

In the case of Sjogrens syndrome, white blood cells called lymphocytes mistakenly target, attack and damage your moisture-producing glands. They can also damage other organs, including your lungs, kidneys and liver.

Sjogrens syndrome that results from a rheumatic condition is classified as secondary Sjogren's syndrome. Primary Sjogren's syndrome occurs by itself.

You can relieve many of the symptoms of Sjogren's syndrome with a self-care plan you can develop with your doctor. He or she will likely review the medications that you're taking to be sure they're not contributing to the problem. Your doctor may also prescribe medication to help ease certain symptoms.

. . . Medications
    Nonsteroidal anti-inflammatory drugs (NSAIDs) This group of medications, which includes aspirin, helps relieve both pain and inflammation. Your doctor may recommend you take these medications if you have painful or swollen joints. Side effects may include indigestion and stomach bleeding. Therefore, always take NSAIDs with food. Prescription NSAIDs can provide higher doses and more potency than do over-the-counter types of NSAIDs.
    Your ophthalmologist may recommend topical nonsteroidal eyedrops, but they need to be used with caution because they may affect your cornea. Your doctor will want to monitor you closely while you're using these eyedrops.
    Corticosteroids These medications reduce inflammation and may slow joint damage. In the short term, corticosteroids can make you feel dramatically better. But when used for many months or years, they may become less effective and also cause serious side effects. Your ophthalmologist may recommend topical corticosteroid eyedrops for short-term use.
    Hydroxychloroquine (Plaquenil) This antimalarial drug may be useful if you have inflamed joints, as with rheumatoid arthritis.
    Pilocarpine (Salagen) Your doctor may prescribe pilocarpine if you have dry-mouth symptoms caused by Sjogren's syndrome. It's not an option if you have poorly controlled asthma, inflammation of the iris, glaucoma or significant cardiovascular disease, or if you're pregnant or breast-feeding.
    Cevimeline (Evoxac) This prescription medication also is used to relieve symptoms of a dry mouth. It works by causing certain mouth glands to produce more saliva.
    Cyclosporine Your ophthalmologist may recommend you use eyedrops containing cyclosporine (Restasis) to treat symptoms of Sjogren's syndrome that affect your eyes.
    Immunosuppressants These medications, such as cyclophosphamide (Cytoxan), methotrexate (Rheumatrex), mycophenolate (CellCept) and azathioprine (Imuran), suppress the immune system. Your doctor may prescribe them for you if you develop problems with your lungs, kidneys, blood vessels or nervous system.
. . . Surgery

One way to relieve dry eyes is to undergo a minor surgical procedure to seal the tear ducts that drain tears from your eyes. Collagen or silicone plugs are inserted into the ducts for a temporary closure. Collagen plugs eventually dissolve, but silicone plugs will keep ducts sealed until they fall out or are removed. Your doctor may use a laser to permanently seal your ducts.
. . . Experimental therapies
  • One small study found that the injected medication rituximab (Rituxan) improved Sjogren's symptoms, but more research is needed to confirm these findings.
  • In other clinical studies, researchers found that etanercept (Enbrel) and dehydroepiandrosterone weren't effective for Sjogren's.
  • Early studies using oral interferon alpha initially looked promising for the treatment of Sjogren's, but the treatment isn't recommended because subsequent trials weren't able to confirm the early results.
  • Epratuzumab (anti-CD22) is currently being studied for the treatment of Sjogren's syndrome.
  • Drops made from a person's own serum — a blood component — have been reported to be beneficial in patients with severe dry eyes.

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