Everything you should know about Sjögren’s Syndrome

Dryness and joint pains may be due to Sjögren’s Syndrome

Sjögren’s syndrome belongs to the group of systemic autoimmune diseases of unknown origin, in which there is an immune alteration, with production of antibodies that attack the patient’s own structures.

This disease was described by a Swedish ophthalmologist in 1933, Dr. Sjögren, in women suffering from rheumatoid arthritis. Since then, progress has been made in the knowledge of this disease, which can occur in isolation and we know it as primary Sjögren’s syndrome, or it can be associated with other systemic autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis or scleroderma.

Symptoms of Sjögren’s Syndrome

Specialists in Internal Medicine state that the disease most frequently affects women in middle age and the most relevant symptoms are dryness, more or less intense, in the eyes, mouth, skin and genitals. Other manifestations of this disease are joint and muscle pain, enlargement of the parotid glands and lymph nodes, and general symptoms such as tiredness and fever.

Renal, nervous system and other important organ complications are also possible, although they are less frequent. Also, in Sjögren’s syndrome, there is the possibility of the appearance of lymphomas, generally of a low degree of malignancy, but which should always be evaluated at each check-up.

How to detect Sjögren’s Syndrome

The diagnosis is made with the clinical history and physical examination of the patient, and with analytical determinations, which include general blood and urine analysis, rheumatoid factor determination, proteinogram and autoantibody study, mainly antinuclear antibodies, anti SSA/Ro antibodies and anti SSB/La antibodies.

Other important tests to be performed are Schirmer’s test, to confirm dry eyes, determination of the volume of saliva produced during 15 minutes and salivary gland scintigraphy, to confirm decreased saliva production. Sometimes it is necessary to perform imaging studies, such as MRI, to assess the exocrine glands, and also in certain cases it is necessary to confirm the diagnosis by performing a salivary gland biopsy.

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When a patient is seen for dryness, the diagnosis of Sjögren’s syndrome should be considered, but there are many other more frequent causes of dryness, such as physiological dryness in the elderly, dryness caused by psychotropic drugs, dryness in people with depression and anxiety, and other pathologies.

Treatment of Sjögren’s Syndrome

The most important thing in the treatment of patients with Sjögren’s syndrome is an exquisite hygiene of the mouth, with brushing and dragging of food debris after each ingestion.

It is essential to drink liquids frequently, mainly water, at least one and a half liters daily, avoiding sugary juices. It is very important that these patients do not smoke, drink alcohol in moderation, eat a varied diet rich in fruits, vegetables and fish, and avoid fats.

The application of artificial tears in the eyes, as many times as needed, and the application of moisturizing creams on the skin and genital lubricants are of great benefit. Artificial saliva and pharmacological pilocarpine preparations are useful for some patients.

Sucrose drinks, carbonated drinks and artificial juices should be avoided, as well as excessive washing of the skin and highly perfumed products.

As for medications, nonsteroidal anti-inflammatory drugs or hydroxychloroquine can be used for musculoskeletal pain and fatigue, reserving corticosteroids and immunosuppressants for neurological or vasculitis complications, or major organ involvement.