Sjogren's syndrome - what is it? This is called a rather dangerous disease, which is common among women over 40 years old. The clinical picture of the pathology is extremely extensive, the disease affects a large number of different organs and systems. You can get rid of the disease in the early stages. During therapy, certain medications are used.
Sjogren's syndrome can significantly reduce the quality of human life, so treatment should begin as soon as possible. In addition, modern diagnostics allows you to easily determine the presence of the disease and the features of its course. A rheumatologist should deal with the treatment of the disease.
Sjogren's syndrome - what is this disease? In terms of its prevalence, this defect takes the second place among rheumatic disorders of an autoimmune nature. In the United States, about 4 million people suffer from this disease. Most often, adult women after menopause are affected.
Let's try to understand what are the causes, symptoms, treatment and prevention of Sjogren's syndrome. Every person should know about this, since anyone can face this disease.
Sjogren's syndrome - what is it
A serious autoimmune disease, which is accompanied by malfunctioning of the lacrimal and salivary glands. With this syndrome, their activity decreases, which gradually entails increased dryness of the skin and mucous membranes, as well as a decrease in the production of necessary enzymes.
The first manifestations of the disease were described in 1965 by the Swedish ophthalmologist Shegren, in whose honor she got her name. This pathology can develop independently or against the background of other diseases. In addition, she herself can cause other deviations in the functioning of the body.
According to its course, the disease is divided into two types:
- Chronic form. It is characterized by lesions of the glands, develops almost imperceptibly for humans. As the disease progresses, the patient begins to feel an unusual dry mouth, while the salivary glands stop working fully and increase in size.
- Subacute course of Sjogren's syndrome. What it is? A more dangerous form of the disease, its clinical picture is much broader. At an early stage, an inflammatory process develops, the body temperature rises. Gradually, the disease leads to damage to the joints, and then other important systems are involved in the pathological process.
Sjogren's syndrome is an autoimmune disease. In other words, pathology occurs due to deviations in the activity of the immune system. As a result of various failures, the body begins to take its own cells as foreign, against the background of which there is an active production of special antibodies. Inflammation gradually develops, which provokes a decrease in the function of the lacrimal and salivary glands.
Causes of the disease
Doctors still cannot say exactly why autoimmune pathologies appear. So even where Sjögren’s syndrome comes from remains a mystery not only for patients, but also for doctors.
Surely only one thing is known: in the process of the onset of pathology, immunological, genetic, hormonal and even some external conditions take part. Most often, various viruses, for example, herpes, Epstein-Barra, cytomegalovirus, or such serious diseases as rheumatoid arthritis, systemic scleroderma, polymyositis, and lupus erythematosus become the provocateurs of the development of the disease.
If you notice excessive dryness in the nose and crusts that cause discomfort, difficulties when swallowing solid foods, and no tears while peeling onions, you definitely need to visit a rheumatologist.
There are several major risk factors:
- women over 40;
- the presence of chronic infections in the body;
- diabetes;
- digestive tract metabolic abnormalities;
- regular exposure to stress;
- smoking;
- the use of cytostatics, antidepressants, anti-inflammatory and antibacterial drugs;
- genetic predisposition.
Secondary and primary syndrome
There are two types of disease. But with both primary and secondary Sjogren's syndrome, patients complain of the same problems, and the cause of the pathology is the same. What is the difference then? The primary species is an independent disease. But the secondary syndrome is always associated with other pathologies, for example, lupus erythematosus, diabetes mellitus or rheumatoid arthritis.
The mechanism of the development of the disease is an active leukocyte attack of the lacrimal and salivary glands, as well as other tissues. It is this anomaly that results in dryness and crusts in the nose, dry eye syndrome, as well as excessive dryness of the skin and even the vagina.
Both secondary and primary Sjögren’s syndrome are extremely complex, hard-going pathologies. In approximately 90% of all cases of the disease, women are exposed. With regard to overall occurrence, Sjogren's syndrome is diagnosed in approximately 8% of the total world population. Of these, approximately 20-25% is a secondary type of disease. Which is characterized by an autoimmune systemic lesion of connective tissue. The numbers are pretty scary.
Damage to the mucous membranes in itself causes patients a lot of discomfort, but in addition, it can lead to numerous complications that are difficult to treat.
Clinical picture
All symptoms of Sjogren's syndrome are divided into two groups:
- systemic (extra-iron) - manifestations that are not characteristic of this disease;
- glandular - glands are affected, as a result of which their work deteriorates, which leads to the appearance of corresponding signs.
One of the main symptoms of the disease is considered to be excessive dryness of the mucous membranes during nervous and emotional overstrain. The progression of the pathology is characterized by an increase in symptoms. Dryness does not go away, a person has to constantly drink solid foods, he feels the need to moisturize his mouth and use special moisturizing preparations for the eyes.
Glandular disease symptoms
Keroconjunctivitis is one of the main signs of Sjogren's syndrome. It is accompanied by itching and redness of the eyelids, accumulation of fluid in the corners of the eyes. The patient's visual acuity gradually decreases, he experiences severe discomfort in bright light. In addition, profuse lacrimation, clouding of the cornea, trophic ulcers are formed in some places. This is the cause of dry eyes. Due to the penetration of staphylococcus on the membrane, perforation and purulent conjunctivitis develops.
Chronic mumps is the second most common symptom of Sjogren's syndrome. It is characterized by damage to the salivary glands, an increase in the size of the lymph nodes, the occurrence of stomatitis and caries. In the next stage, dryness appears in the throat and nose, an increase in the salivary glands. The patient has to constantly monitor the hydration of the mouth. Symptoms worsen at times with the use of sweets.
In about half the cases, the disease is accompanied by regular exacerbations. As it progresses, an increase in the salivary glands is observed, because of which facial features can even change. Dry tongue and oral mucosa turn red over time, in some cases damage is noted, the consistency of saliva changes - it becomes too viscous and thick, produced in minimal quantities.
In addition, the pathology is accompanied by a number of concomitant symptoms:
- Hoarseness of the voice, inflammation of the mucous membrane of the larynx, hearing impairment due to otitis media. Women develop swelling, atrophy, and vaginal dryness. Over time, due to this, colpitis appears, which is characterized by a decrease in libido, soreness, itching and burning in the reproductive organs.
- No less common symptom of the disease is a decrease in sweating, excessive dryness of the skin. In about 30% of cases, there is a defeat of the sweat glands located in the armpits, external genitalia, and pubis.
- In approximately 80% of cases, the digestive tract is affected. Due to the reduced excretion of the necessary enzymes, sensitivity to dairy and fatty foods is increased several times, deviations in the functioning of the stomach and intestines are noted.
Systemic signs of pathology
In addition, Sjogren's syndrome leads to the appearance of extra-glandular symptoms:
- Bone pain. Identify the cause only with x-rays. In approximately 60% of cases, the disease is accompanied by pain, stiffness of movements, which manifests itself most vividly in the morning. Usually, small bones are involved in the pathological process, but large joints remain intact. In 10% of patients there is intense pain and slight muscle weakness, sometimes polymyositis develops.
- Tracheobronchitis. Appear in half the cases. Against the background of this disease, the patient develops a mild cough, shortness of breath is frequent. Pulmonary fibrosis, vasculitis, or pleurisy may develop. Small rashes appear on the skin, consisting of spots and dots, ulcers form, minor necrosis. The patient feels itching, burning, body temperature rises.
- Polyneuropathy. This condition is characterized by a complete loss or decrease in the sensitivity of the skin on the legs and arms, sometimes brain lesions appear. During the diagnosis, the patient may show abnormalities in the thyroid gland, a tendency to allergic reactions to certain products, drugs and chemicals.
Diagnostics
In fact, Sjogren’s syndrome is not dangerous for human life, but it can significantly lower its quality, causing disability. You can independently detect the disease by dry tongue and the absence of tears during slicing onions. If such signs occur, you must consult a rheumatologist to undergo a full examination, which will also involve oculists and dentists. In addition, the patient may need to consult a neurologist, gastroenterologist and orthopedist.
Due to the similarity of the symptoms of Sjogren's syndrome with the manifestations of other diseases, a number of various studies are required to confirm the suspected diagnosis. The doctor may suggest the presence of the disease if such symptoms occur:
- if a person is constantly forced to use drops to moisten his eyes;
- with swelling of the salivary glands;
- with a feeling of ongoing eye irritation;
- if necessary, drink solid foods;
- dryness does not disappear within three months.
To determine the pathology and assess its severity, a specialist can prescribe several examinations:
- blood test for the presence of antinuclear bodies, which are markers of the inflammatory process;
- test with Schirmer stripes - involves placing a narrow strip of special paper under the lower eyelid, which should get wet in just 5 minutes;
- salivary gland biopsy;
- MRI and ultrasound to visualize inflamed areas;
- general blood analysis;
- fundus examination with a special lamp;
- staining the cornea with a pink solution;
- sialometry - is necessary to evaluate the salivary glands.
Only after a full diagnosis will the doctor be able to prescribe a suitable treatment tactic.
Therapy Features
In fact, Sjogren's syndrome is a very serious, but not fatal problem. If you identify the symptoms of the disease in time and start treatment, the risk of complications will be minimal. For patients, only one thing is important - to remember the importance of a healthy lifestyle. Only in this way can immunity be strengthened, which will prevent the pathological process from developing further.
Today, Sjogren's syndrome is successfully treated, but it is impossible to completely get rid of the disease. So after a patient is diagnosed, only symptomatic therapy awaits.
Complex treatment makes it possible to minimize the manifestations of the disease and prevent the appearance of various complications. Self-medication in this case is strictly prohibited, since such a decision may entail an aggravation of the clinical picture.
In the early stages, doctors recommend taking immunosuppressants and hormones. Immunosuppressants and glucocorticosteroids are used to stop inflammation. These drugs slow down the immune system and reduce its attacks on their own organs. If the patient’s immune system is severely weakened, the doctor may prescribe antibiotics to prevent secondary infections.
Clinical recommendations for Sjogren's syndrome
The treatment of this disease provides for maximum relief of the patient's condition and the fight against autoimmune failure:
- With reduced saliva production, Pilocarpine and its analogues are used. In addition, patients are advised to drink as much fluid as possible.
- When dry eyes apply drops "Artificial Tear". The price of this drug is considered affordable. Hypromellose-based preparations are considered equally effective, and in the evenings it is recommended to lay therapeutic ointments under the eyelids. According to reviews, the "Artificial Tear" drops have the best effect. The price of the drug ranges from 120-210 rubles. They bring quick relief to dry eyes and provide a long lasting effect.
- During exacerbations, antipyretic drugs should be taken.
- If the patient is tormented by pain associated with pathologies of the musculoskeletal system or myalgia, non-steroidal anti-inflammatory drugs are used.
- Applications based on Heparin, Hydrocortisone and Dimexidum effectively fight inflammation of the glands.
- With dry bronchi and trachea, it is recommended to use Bromhexine.
- To eliminate dry mouth, rinses are used.
- Dry eye syndrome is eliminated with saline and Haemodesus. But before use, it is better to consult a doctor.
- What to do with vaginal dryness? Doctors recommend using special lubricants and taking antifungal drugs.
- Often, dryness in the oral cavity entails the appearance of caries. To prevent problems, doctors advise you to constantly monitor hygiene, regularly visit a dentist and use fluoride pastes.
- Sometimes doctors also recommend reducing physical activity and changing your diet. If a stable remission is observed, the use of alternative means is allowed.
Most often, doctors prescribe several effective drugs:
- "Prednisolone" - glucocorticoid;
- "Solcoseryl" and "Parmidin" - angioprotectors;
- "Splenin" - an immunomodulator;
- "Heparin" - an anticoagulant;
- Cyclophosphamide, Azathioprine, Chlorobutin - cytostatics;
- "Trasilol", "Contrical" - stop the production of certain enzymes.
Nutrition principles
There is no specific diet for Sjogren's syndrome, but there are certain nutritional principles that help minimize unpleasant symptoms. In addition, if you take into account the health of the oral cavity, then just the right diet is designed to protect your teeth from aggressive effects.
Doctors advise in the first place to abandon alcohol. In addition, foods containing large amounts of fruit acids should be excluded from the daily menu.
The main diet of a person with a diagnosis of Sjogren's syndrome should consist of liquid dishes. Doctors advise supplementing treats with a variety of sauces, juicy fruits and vegetables, for example, tomatoes and cucumbers.
The most suitable food option is considered a menu with a lot of fresh products and a minimum amount of sweets and saturated fats.
Likely Consequences
Patients who do not treat the disease may experience a number of unpleasant complications:
- the occurrence of folds in the tongue, difficulty swallowing;
- complete disappearance of saliva;
- keratinization of the skin from the inside of the cheeks;
- secondary infection;
- cracking and tooth loss, caries;
- various causes of dry eyes can lead to visual impairment;
- fungal infections - stomatitis, candidiasis;
- pathologies of the chest organs - pleurisy, bronchitis, pneumonia, respiratory failure;
- renal failure and other impaired renal function;
- numbness or loss of mobility of the arms and legs;
- lymphoma
People with a diagnosis of Sjogren's syndrome quite often develop malignant tumors. Most often, such patients experience salivary gland lymphosarcoma.
Relapse prevention
To prevent further development and exacerbation of the clinical picture with Sjogren's syndrome, it is recommended:
- reduce the load on the vocal cords and eyes;
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Lack of timely therapy and neglect of the doctor’s instructions is fraught with loss of working capacity, disability and damage to various organs.
Now you know everything about the causes, symptoms, treatment and prevention of Sjogren's syndrome. As you can see, this is a rather serious disease, but not dangerous to human life. And if you follow all the doctor’s recommendations, you can completely forget about all sorts of discomfort that provokes the symptoms of pathology.