The average age of a Sjogren’s diagnosis is 40; however, the disease can manifest at any time. Although women make up 90% of those diagnosed, men can also be affected and may go undiagnosed.
Sjogren’s syndrome is an immune system condition that lasts a long time. This disorder is autoimmune, meaning the body’s immune system erroneously attacks healthy tissues and cells.
As a result of white blood cell infiltration into exocrine glands, salivary and lacrimal secretions are diminished. This can cause your mouth, eyes, skin, nose, upper respiratory system to dry up and your vaginal area.
It is linked to other autoimmune diseases such as biliary cholangitis (primary), rheumatoid arthritis, and SLE. Although Sjogren’s is a severe disease, it may be managed well, reducing the risk of complications and tissue damage.
Once patients receive treatment, they often have good control over their illness.
Sicca Syndrome: What Is Happening In It?
Basically, the immune system, which usually wards off diseases like cancer and infections, attacks healthy cells in the body.
The development of autoantibodies in the blood, which react to the body’s own proteins, is a contribution to this condition.
When glands responsible for producing tears and saliva become injured and dysfunctional due to inflammation and infiltration by blood cells termed lymphocytes, the output of these glands (in the form of tears and saliva) decreases.
According to the studies, the condition may be triggered by the interaction of genetic predisposition and sex hormones with an environmental agent, such as a viral infection.
Risk Factors
In most cases, the following risk factors contribute to the development of Sjogren’s syndrome:
- People above the age of 40 tend to have Sjogren’s syndrome.
- Sjogren’s syndrome mostly affects females.
- Patients with Sjogren syndrome (aka sicca syndrome) often suffer from another rheumatic condition, including lupus or rheumatoid arthritis.
Sicca Syndrome: Symptoms
The most typical signs of this illness are dry eyes and a dry mouth.
Mouth and Throat Symptoms:
- Dry mouth and difficulty swallowing
- Problems with expression Loss of taste
- Having saliva that is very thick or stringy
- Discomfort or soreness in the mouth
- Cavities and Gum diseases
- Hoarseness
Eye Symptoms:
- Red, itchy eyes
- The eyes are burning.
- The uneasy sensation that something is staring back at you
Aside from these, you could also experience:
- Fever
- Fatigue
- Experiencing a change in the skin tone of feet or hands as a result of cold (Raynaud phenomenon)
- Feeling sick and having acid reflux
- Soreness or oedema in the joints
- Abnormal cardiac rhythm
- Symptoms of a gland swelling
- Rash neuropathy-related tingling and discomfort in the extremities
- Lung disease symptoms include cough and shortness of breath
- Symptoms such as dryness of the vaginal tissue or discomfort during urinating
Sicca Syndrome: Diagnosis
Sjögren’s syndrome can be diagnosed if you experience dry lips, eyes, and other symptoms.
Your doctor may perform the following tests:
History
Depending on your medical history, your doctor may diagnose you with secondary Sjögren’s syndrome if you also suffer from dry eyes, a dry mouth, and an autoimmune disorder.
Imaging
Among the imaging procedures available is sialometry, which uses X-rays that may detect dye injected into the salivary glands to determine how much saliva is being produced. Salivary scintigraphy is another option; it measures how long it takes for a radioactive isotope to go from the injection site to the salivary glands.
Antibodies (Blood Tests)
Anti-SSA (also known as anti-Ro) and anti-SSA type B (also known as anti-Ro) are tested for, as are ANA (anti-nuclear antibodies) (anti-SSB, also called anti-La). Rheumatoid factor, an antibody in the blood of many persons with rheumatoid arthritis, may also be detected with a blood test.
Biopsy
Salivary gland or inner lip tissue or cells may be taken for biopsy. Researchers will examine the biopsy sample for inflammatory markers.
Eye Exam
The number of tears produced can be determined by having an eye exam performed by a trained professional, such as an ophthalmologist. Your doctor will check the cornea, the transparent front section of your eye, for signs of dryness during a routine eye checkup.
Sicca Syndrome: Treatment
Some people with Sjögren’s have found relief from joint discomfort, exhaustion, and rashes by using the antimalarial medicine hydroxychloroquine.
Corticosteroids (such as prednisone and methylprednisolone) or immunosuppressive drugs such as methotrexate, azathioprine, mycophenolate mofetil, leflunomide, or cyclophosphamide may be necessary for patients with systemic problems such as fever, severe rash, lung disease, and neurologic problems. In cases of advanced illness, biological treatments such as rituximab may be employed.
Cyclosporine and lifitegrast eye drops, which reduce inflammation in the glands surrounding the eyes, may considerably alleviate symptoms and lessen the need for artificial tears.
You may find relief from the dry mouth by consuming fluids, utilising sugar-free gums and sweets sweetened with xylitol or using saliva substitutes. Saliva-stimulating prescription drugs, including pilocarpine and cevimeline, are helpful for many people.
Antifungal medications may be required if a patient develops a yeast infection.
Nasal dryness might be alleviated by using a humidifier or saline irrigation.
Acid reflux symptoms may be alleviated by taking medications that lower stomach acid levels (such as proton-pump inhibitors and H2 blockers).
In order to avoid problems like tooth decay and loss of teeth, everyone has to visit the dentist regularly.
The most effective treatments for dry eyes are artificial tears used several times a day and an ointment administered before bed. In extreme circumstances, an ophthalmologist may obstruct the patient’s tear ducts.
Those who suffer from dry eyes should have routine checkups with an ophthalmologist or optometrist to detect early symptoms of corneal damage. Those experiencing severe eye discomfort and redness should get checked for infections.
Sicca Syndrome: Complications
Here are the complications that you should be aware of:
- Any injury or damage to the eye
- Hypothyroidism
- Complications during pregnancy, such as a rash or potentially life-threatening heart defects in the baby
- Lung fibrosis (scarring), infections or bronchiectasis
- Probability of acquiring non-Hodgkin lymphoma rises
Conclusion
Even though Sjögren’s disease symptoms like dry mouth and dry eyes cannot be cured, they need not cause you discomfort.
You should discuss how the sickness influences your daily life honestly with your doctor. A mix of treatments may be necessary to alleviate symptoms, but your doctor can help you identify the best course of action.
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