SJOGRENs
SYNDROME

• What is Sjogren's Syndrome?
• What is going on in the body?
• What are the signs and symptoms of the disease?
• What are the causes and risks of the disease?
• What can be done to prevent the disease?
• How is the disease diagnosed?
• What are the long-term effects of the disease?
• What are the treatments for the disease?
• What are the side effects of the treatments?
• What happens after treatment for the disease?
• How is the disease monitored?
  

• Sjögrens syndrome is an autoimmune disorder that causes a major decrease in lubricating fluids, such as tears and saliva. An autoimmune disorder is one in which the person's body attacks its own tissues for unknown reasons.
  
  
• In Sjögren syndrome, the body's natural defense mechanisms invade and destroy the moisture-producing glands in the body. These glands produce saliva, tears, and other lubricating fluids. Since the body produces less saliva and fewer tears, the eyes and mouth become dry. A person may have Sjögren syndrome alone as Primary disease or with or Secondary to, other autoimmune disorders which include rheumatoid arthritis and systemic lupus erythematosus.
  
  
• Symptoms associated with the decreased saliva in Sjögren syndrome are as follows:
  · burning sensation in the mouth
  · difficulty speaking at length
  · difficulty swallowing dry food
  · dry mouth
  · increase in dental cavities or mouth sores
  · problems wearing dentures
  
  Following are some of the symptoms associated with decreased tearing:
  · dry, red eyes
  · eye fatigue or strain
  · increased sensitivity to light
  · itching, burning sensation
  · sandy or gritty feeling under the eyelids
  · severe eye pain, caused by corneal injuries
  · thick, stringy material oozing from the corners of eyes
  
  A wide variety of other symptoms may be seen if the disease attacks other body organs.
  It may attack the kidney, intestine, stomach, blood vessels, lungs, liver, pancreas, brain, and nerves.
  Many individuals with Sjögren syndrome have severe joint pain and fatigue.
  Women with Sjögren syndrome may notice vaginal drying.
  
  
• Sjögren syndrome occurs in about 2 out of 10,000 people.
  People with Sjögren syndrome produce antibodies against the moisture-producing tissues in their own bodies for some unknown reason.
  Sjögren syndrome occurs in more women than men at a ratio of 9:1.
  It affects mostly middle-aged women but can occur in all ages.
  30% of people who have other autoimmune disorders (such as lupus) also suffer from secondary Sjögren syndrome.
  
  
• There is no known prevention for Sjögren syndrome.
  
  
• The diagnosis of Sjögren syndrome begins with a history and physical exam.
  A series of blood tests may be ordered.
  Special tests may be done to check saliva production.
  Eyes are checked for corneal injuries, or scratches.
  The eyes are also checked for their ability to produce tears (litmus test/schirmers test).
  Sometimes a small sample of a gland that produces saliva is removed from your lip and checked under a microscope.
  
  
• The course of Sjögren syndrome is highly unpredictable.
  It may get worse, get better or stay the same.
  The most common long-term effects are due to the loss of lubricating fluids of the eyes and mouth.
  A person will need to prevent injuries to the eyes and mouth.
  
  
• A person with Sjögren syndrome usually uses artificial tears to keep the eyes moist.
  Artificial saliva can be used to prevent dry mouth such as pilocarpine hydrochloride and cevimeline which are available by prescription to help dry mouth. (also known as Saligen)
  Frequent sips of water throughout the day may also be helpful.
  Other helpful products include unscented skin lotion, saline nasal spray, and vaginal lubricants.
  
  An individual with Sjögren syndrome should avoid medications that are known to dry up secretions.
  These medications include antihistamines, decongestants, and some sleeping and opioid medications.
  Any other autoimmune disorder present will also need treatment.
  
  Medications are sometimes used to reduce the effects of the immune system on body tissues.
  These medications may include immunosuppressive medications, nonsteroidal anti-inflammatory drugs, or NSAIDs, and corticosteroids such as prednisone.
  
  There are punctal plugs available for the 2 lower punctum ducts which drain away any moisture/tears produced by the lacrimal/tear ducts in each eye.
  These plugs can be permanent or they can be temporary, dissolvable collagen or temporary and removable silicone; both of which can be inserted into the ducts in your opthamologist's office, painlessly and in a very short period of time.
  A more invasive and permanent solution which can also be used is to cauterize the ducts closed; this is not used so much now due to the risks involved which are unnecessary with the new and simpler plugs..
  
  

• The artificial tears and saliva have no bad side effects, just a temporary lubricating that is soothing to the patient.
  Medications that suppress the body's immune system can leave a person more likely to get infections.
  
  

• Treatment of Sjögren syndrome is lifelong.
  Complications may include increased dental cavities, kidney failure, and sores or scratches on the eye that can lead to blindness.
  
  
• Any new or worsening symptoms should be reported to the healthcare provider who will adjust the treatment accordingly.