Sjogren's Syndrome | Causes, Clinical features, Diagnosis & Treatment

Summary

Sjogren'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.
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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.