Sjogren's Syndrome | Causes, Clinical features, Diagnosis & Treatment
Summary
TLDRSjogren's syndrome is a chronic autoimmune disease that primarily affects the moisture-producing glands, leading to dry mouth (xerostomia) and dry eyes (keratoconjunctivitis sicca). It is categorized into primary and secondary forms, with the latter often associated with other autoimmune diseases like rheumatoid arthritis or SLE. The exact cause is unknown, but genetic and hormonal factors, along with environmental triggers, may play a role. Treatment is supportive, focusing on symptom relief through artificial tears and saliva, and managing complications like dental decay and secondary infections.
Takeaways
- 🕵️♂️ Sjogren's syndrome is a chronic systemic autoimmune disease recognized and named by Dr. Henrik Sjogren in 1933.
- 💧 The syndrome primarily affects exocrine glands, leading to decreased tear and saliva production, causing dry mouth (xerostomia) and dry eyes (keratoconjunctivitis sicca).
- 🏥 There are two forms: primary Sjogren's syndrome, which only affects exocrine glands, and secondary Sjogren's syndrome, which occurs alongside another autoimmune disease.
- 🧬 The exact cause is unknown, but genetic factors, sex hormones, and environmental factors like viral or bacterial infections may trigger the disease.
- 👩⚕️ Sjogren's syndrome is more common in women, especially middle-aged, and is associated with female estrogen.
- 🔬 The disease process involves the activation of T cells and B cells, leading to the production of anti-nuclear autoantibodies, which contribute to glandular destruction.
- 👄 Oral symptoms include dry mouth, difficulty swallowing, and potential dental decay, while ocular symptoms involve dry, inflamed eyes with a sensation of dryness or foreign body.
- 🩺 Diagnostic tests include Schirmer's test for tear flow, sialometry for salivary flow, and blood tests for anti-SSA and anti-SSB autoantibodies.
- 💊 Treatment is supportive, aiming to reduce symptoms through artificial tears, saliva, medications to stimulate salivary flow, and oral hygiene to prevent dental decay.
- 🌐 The video encourages viewers to subscribe, like, share, and comment for more information and support, and provides a link to a Patreon page for additional resources.
Q & A
What is Sjogren's syndrome?
-Sjogren's syndrome is a chronic systemic autoimmune disease that affects moisture-producing exocrine glands, primarily the salivary and lacrimal glands, causing dryness of the mouth (xerostomia) and eyes (keratoconjunctivitis sicca).
Who first recognized and named Sjogren's syndrome?
-Sjogren's syndrome was recognized and named by Dr. Henrik Sjogren in 1933.
What are the two forms of Sjogren's syndrome?
-The two forms of Sjogren's syndrome are primary Sjogren's syndrome and secondary Sjogren's syndrome.
How does primary Sjogren's syndrome differ from secondary Sjogren's syndrome?
-In primary Sjogren's syndrome, only the moisture-producing exocrine glands are affected, and no other autoimmune disease is present. In secondary Sjogren's syndrome, patients experience another associated autoimmune disease in addition to Sjogren's syndrome.
What is the most common associated autoimmune disease in secondary Sjogren's syndrome?
-The most common associated autoimmune disease in secondary Sjogren's syndrome is rheumatoid arthritis.
What are some possible triggers for the development of Sjogren's syndrome?
-Possible triggers for Sjogren's syndrome include genetic factors, sex hormones, and environmental factors such as viral or bacterial infections.
Which gender is more commonly affected by Sjogren's syndrome and why?
-Sjogren's syndrome is more common in women, likely due to the influence of female estrogen, and it mostly affects middle-aged women between 40 to 60 years.
What is the role of T cells in the pathophysiology of Sjogren's syndrome?
-In Sjogren's syndrome, T cells abnormally activate and consider the nuclear components of the salivary cells as foreign antigens, leading to the production of cytokines and activation of B cells, which produce anti-nuclear autoantibodies.
What are the common oral symptoms of Sjogren's syndrome?
-Common oral symptoms include a dry mouth, difficulty in swallowing, altered speech, difficulty wearing dentures, a fissured tongue, and red and painful oral mucosa due to secondary candidiasis.
How can the severity of dry eye in Sjogren's syndrome be assessed?
-The severity of dry eye can be assessed using Schirmer's test, which measures the amount of tears produced over a period of time by placing a strip of paper under the eye.
What is the treatment approach for Sjogren's syndrome?
-The treatment for Sjogren's syndrome is supportive, aiming to reduce symptoms. It includes the use of artificial tears for dry eyes, artificial saliva for dry mouth, medications to stimulate salivary flow, and oral hygiene practices to prevent dental decay.
Outlines
🧬 Understanding Sjogren's Syndrome
Sjogren's syndrome is a chronic autoimmune disease named after Dr. Henrik Sjogren, who recognized it in 1933. It primarily affects exocrine glands responsible for moisture production, such as the salivary and lacrimal glands, leading to dry mouth (xerostomia) and dry eyes (keratoconjunctivitis sicca). The disease is categorized into primary and secondary forms, with the latter often associated with other autoimmune conditions like rheumatoid arthritis or systemic lupus erythematosus (SLE). The exact cause remains unknown, but it's believed that genetic factors, sex hormones, and environmental triggers like infections might play a role. Women, particularly middle-aged, are more commonly affected. The pathophysiology involves the immune system mistakenly attacking the body's own cells, leading to inflammation and damage to the glands, which in turn causes the characteristic symptoms.
🩺 Diagnosis and Management of Sjogren's Syndrome
Diagnosing Sjogren's syndrome involves tests such as Schirmer's test for tear production and sialometry for salivary flow, along with blood tests to detect specific autoantibodies like anti-SSA and anti-SSB. A lip biopsy may also reveal immune cell infiltration in the salivary glands. Treatment is supportive, aiming to alleviate symptoms. For dry eyes, artificial tears are recommended, and for dry mouth, artificial saliva or medications like pilocarpine can stimulate saliva production. Maintaining oral hygiene and using fluoride applications can help prevent dental decay, a common issue due to reduced saliva. Anti-fungal therapy may be necessary for secondary infections like candidiasis. The video concludes by encouraging viewers to engage with the content through likes, subscriptions, and sharing, and invites questions and comments for further discussion.
Mindmap
Keywords
💡Sjogren's Syndrome
💡Exocrine Glands
💡Xerostomia
💡Keratoconjunctivitis Sicca
💡Autoimmune Disease
💡Rheumatoid Arthritis
💡Systemic Lupus Erythematosus (SLE)
💡Anti-SSA and Anti-SSB Antibodies
💡Schirmer's Test
💡Salivary Gland Biopsy
💡Supportive Treatment
Highlights
Sjogren's syndrome is a chronic systemic autoimmune disease named after Dr. Henrik Sjogren.
It primarily affects the salivary and lacrimal glands, leading to dry mouth (xerostomia) and dry eyes (keratoconjunctivitis sicca).
There are two forms: primary Sjogren's syndrome and secondary Sjogren's syndrome, which is associated with other autoimmune diseases.
Primary Sjogren's syndrome only affects exocrine glands, while secondary involves another autoimmune disease.
Secondary Sjogren's syndrome is often associated with rheumatoid arthritis or systemic lupus erythematosus (SLE).
The exact cause of Sjogren's syndrome is unknown, but it's believed to involve genetic factors, sex hormones, and environmental triggers like infections.
Genetic factors may include malformed genes in immune cells, and sex hormones like estrogen, which may explain the higher prevalence in women.
The disease process begins with infection of salivary glands, leading to the exposure of nuclear components to antigen-presenting cells.
Abnormal activation of T cells and production of cytokines lead to the activation of B cells and the creation of anti-nuclear autoantibodies.
Autoantibodies target the glands, causing further destruction and reduction in salivary flow.
Symptoms vary, but common oral symptoms include a dry mouth, difficulty swallowing, and potential dental issues.
Ocular symptoms are characterized by dry eyes, scratchy sensation, and potential blurred vision.
Dryness can also affect other areas with exocrine glands, such as the skin, nose, sinuses, throat, ears, and vagina.
Schirmer's test and salivary flow measurement are used to assess tear and saliva production, respectively.
Blood tests can detect the presence of anti-SSA and anti-SSB autoantibodies, which are indicative of Sjogren's syndrome.
A lip biopsy can reveal infiltration of minor salivary glands with immune cells, which is characteristic of the disease.
Treatment is supportive, aiming to reduce symptoms, and includes artificial tears for dry eyes and artificial saliva for dry mouth.
Patients are at an increased risk of dental decay, and daily fluoride applications are recommended.
Anti-fungal therapy may be necessary to treat secondary candidiasis, a common complication of dry mouth.
Transcripts
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shogren's syndrome is a chronic systemic
and autoimmune disease that became
recognized and named by Dr Henrik
shogren in 1933.
the disease affects moisture producing
exocrine glands located all over the
body
primarily the salivary and the lacrimal
glands causing a decrease in tears and
saliva production resulting in dryness
of the mouth called xerostomia and
dryness of the eyes called zero of
thumbia
two forms of Sjogren's syndrome are
recognized so far the primary sjogren
syndrome and the secondary chagrance
syndrome
in primary sjogren syndrome which is
also known as zika syndrome only the
moisture producing exocrine glands are
affected and no other autoimmune disease
is present
however in secondary Sjogren's syndrome
patients experience another Associated
autoimmune disease in addition to
Sjogren's syndrome
the associated autoimmune disease in 15
of patients is rheumatoid arthritis in
addition secondary Sjogren's syndrome
may also develop in 30 percent of
patients with systemic lupus
erythematosis or SLE
coming to the causes of Sjogren's
syndrome the exact cause of Sjogren's
syndrome is not known however research
suggests that genetic factors and sex
hormones when combined with an
environmental Factor such as a viral or
a bacterial infection May trigger the
development of Sjogren's syndrome
the genetic factors can be the presence
of a malformed gene in the body's immune
cells and the sex hormone can be the
female estrogen indicating the condition
much more common in women than men
mostly affecting middle aged women
between 40 to 60 years
let's look into the pathophysiology of
Sjogren's syndrome the disease process
starts when salivary glands become
infected with a viral or a bacterial
infection this causes salivary cells to
break down and expose their nuclear
components to circulating antigen
presenting cells
these nuclear components are picked up
by the antigen presenting cells and are
presented to the cd8 or T cells
the T cells get abnormally activated in
patients with Sjogren's syndrome and
consider the nuclear components of the
salivary cells as foreign antigens the T
cells then produces cytokines and
further activate B cells which then
produce anti-nuclear autoantibodies or
anas against these antigens
the anti-nuclear autoantibodies are the
anti-ssa and the anti-ssb auto
antibodies produced against SSA and SSB
antigens together the anti-nuclear auto
antibodies and the T and B cells reach
the site of glandular destruction and
promote cellular breakdown by recreating
more immune cells and producing more
Auto antibodies in the area hence
resulting in further loss of the
secretary cells of the glands which
ultimately results in a reduction of
salivary flow
the severity of the disease differs in
individuals the principal oral symptom
of Sjogren's syndrome includes a dry
mouth
patients experience difficulty in
swallowing authored speech or difficulty
in wearing dentures
the dryness of the mouth reaches to the
extent the tongue becomes fissured and
Exhibits a trophy of the papillae
oral mucosa might become red and painful
as a result of secondary candidiasis
bilateral enlargement of the major
salivary glands which are usually
non-painful may also be observed
furthermore the reduced amount of saliva
production causes a lack of salivary
cleansing action which predisposes the
patient to dental decay the ocular
symptoms can be presented by the term
keratoconjunctivitis Seca
in keratoconjunctivitis Seeker the eyes
become dry which causes patients to
complain of a scratchy sensation or the
feeling of presence of a foreign body in
the eye the conjunctival epithelium
becomes inflamed resulting in blurred
vision and sometimes an aging pain in
the eyes
are the most common symptoms dryness can
also occur in areas where these Master
producing exocrine glands are located
such as Skin and mucosa resulting in dry
areas including the skin nose sinuses
throat ears and in women the vagina
schimmer's test can be used to assess
the flow of tears and is done by holding
a strip of paper under the eye and
measuring the amount of Tears over a
period of time
similarly salometry can be done to
measure salivary flow
and blood tests of course can be used to
indicate the presence of anti-ssa and
anti-ssv auto antibodies
lip biopsy indicates infiltration of
minor salivary glands with immune cells
the treatment for patients with sugar
syndrome is supportive and aims at
reducing the patient's symptoms dry eyes
are best managed with the periodic use
of artificial tears similarly artificial
saliva can be used for the treatment of
dry mouth
medications such as phylocarpine can be
useful to stimulate salivary flow
Sensations with children syndrome are at
an increased risk of dental decay daily
fluoride applications are indicated
symptoms can also be relieved by the use
of oral hygiene products like mouth
rinses and regular truth brushing
anti-fungal therapy is needed to treat
secondary candidiasis
so this was all about Sjogren's syndrome
I hope this video helps if you think
this video was really helpful please do
like subscribe share and comment if you
have any questions thank you for
watching
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