Sjögren’s syndrome

Sjögren’s syndrome is a classic autoimmune disease. Although the disease is relatively rare, it causes many troubles and it is important to know some basic information about this pathological condition. Sjögren’s syndrome is more typical for women, but it can also affect men. It occurs either alone or together with other autoimmune diseases.

Causes

Sjögren's syndrome is probably based on a genetic predisposition, which combines with some outer factor, probably a banal viral infection. The combination of these factors leads to abnormal reprogramming of our immune system that begins to attack our own tissues and organs. In Sjögren’s syndrome, the most affected tissues are salivary, lacrimal and other glands (pancreas, vaginal glands and parotid glands).

Symptoms

The symptoms are based on functions of the affected cells. Damage to cells of the salivary glands results in reduced production of saliva and dry mouth (xerostomia), swallowing disorders and eating disorders. The lack of saliva causes bad breath and increased tooth decay, because saliva includes many substances with antibacterial effect. Decreased tear production results in dry eyes (xerophthalmia), eye irritation and intolerance of sunlight. Women may suffer from affection of vaginal glands causing inadequate lubrication and pain during sexual intercourse. Pancreatic tissue is damaged less commonly and it results in decreased production of digestive pancreatic juice. Patients with exocrine pancreatic insufficiency have problems with absorption of nutrients from the small intestine, manifesting with bulky, oily and smelly stool. When the autoimmune process attacks parotid glans, it causes their swelling (similar symptoms to mumps).

Diagnosis

The combination of the mentioned symptoms is suspicious and the doctor may use special Schirmer’s test. It is very simple and gives us information about tears production. A stripe of a filter paper is inserted under the lower eyelid and left there for a period of time. The doctors evaluate the distance of humidity caused by tears. The diagnosis also uses confirmation of various autoantibodies (antibodies aggressive against our own tissues) by serologic methods from a blood sample.

 

Schirmer's test

 

Scheme - principle of Schirmer’s test

 

Treatment

The disease is incurable and we have to focus on treatment of the symptoms. Decreased production of saliva and swallowing troubles can be solved by frequent drinking and especially washing down bites of food. The lack of tears is solved by regular usage of moistening ocular droplets. Women with sexual troubles may use artificial lubricants and people with pancreatic dysfunction may take digestive enzymes in special capsules.