Sjogren's syndrome

Sjogren's syndrome

Sjögren's syndrome is an autoimmune disease that generally affects the salivary and tear glands. This condition mostly affects people aged 40 and over, and is more common in women than men.

Sjögren's syndrome is usually characterized by dry mouth and dry eyes. Even so, not all people with dry mouth and dry eyes suffer from Sjögren's syndrome. People with Sjögren's syndrome may also experience other symptoms, such as blurred vision or difficulty speaking .

Sjögren's syndrome is a disease that develops in the long term (chronic). Based on the process of occurrence, Sjögren's syndrome is divided into two types, namely:

  • Primary Sjögren's syndrome, which occurs on its own without an initial onset of another autoimmune disease
  • Secondary Sjögren's syndrome, which occurs in people with another autoimmune disease, such as lupus, scleroderma, or rheumatoid arthritis

Causes of Sjögren's Syndrome

Sjögren's syndrome occurs when the body's immune system attacks healthy cells in the fluid-producing glands. It is not known exactly why this happened. However, it is suspected that Sjögren's syndrome is associated with the following:

  • Genetic
    Certain genes make a person more susceptible to autoimmune conditions, especially if there is an infection as a trigger, both bacterial and viral infections.
  • The hormone
    estrogen is believed to play a role in the emergence of this disease. Therefore, Sjögren's syndrome is more common in women.

Sjögren's syndrome generally affects the glands that produce tears and saliva. However, this condition can also attack other parts of the body, such as the thyroid gland, joints, nerves, kidneys, liver, lungs and skin.

Although the cause is unknown, there are several factors that are known to increase a person's risk of experiencing Sjögren's syndrome, namely:

  • Over 40 years old
  • Female gender
  • Suffering from another autoimmune disease , such as rheumatoid arthritis or lupus

Symptoms of Sjögren's Syndrome

The main symptoms of Sjögren's Syndrome are dry eyes ( xerophthalmia ) and dry mouth ( xerostomia ). Different from dry eyes and dry mouth in general, these two conditions will feel more severe in people with Sjögren's syndrome.

Dry eye symptoms in Sjögren's syndrome can cause complaints in the form of:

  • Blurred vision
  • Eyelids feel sore, red, and swollen
  • Burning and itching in the eyes
  • A feeling of stuffiness and dryness in the eyes
  • Discomfort when looking at a light source
  • Eyelids feel sticky when you wake up
  • Mucus discharge from the eye
  • Eyestrain

Meanwhile, complaints that can arise due to dry mouth include:

  • hoarse voice
  • It's hard to talk
  • Difficulty swallowing food, especially dry food
  • Always need to drink when eating to help swallow food
  • Changes in the ability to taste on the tongue so that the taste of food changes
  • Lips are dry and chapped at the corners of the mouth
  • Tongue reddish and feels smooth
  • The emergence of other oral disorders, such as tooth decay, gum disease, and canker sores

In addition, there are also other symptoms that can arise due to Sjögren's syndrome, such as:

  • Joints that feel painful, stiff, and swollen
  • Dry and itchy skin
  • Dry cough that doesn't go away
  • Stomach upset
  • Headache
  • Hard to breathe
  • Skin rash, especially after sun exposure
  • Difficulty thinking, concentrating, or remembering
  • Muscle ache
  • Hard to sleep
  • Feeling very tired and fatigued
  • Numbness and tingling, especially in the feet and hands
  • Dry vagina
  • Inflammation of the blood vessels ( vasculitis )
  • Swelling, infection, or stones in the salivary glands

When to see a doctor

The symptoms of Sjögren's syndrome can mimic those of other, more serious conditions. Therefore, immediately consult a doctor if you experience symptoms of Sjögren's syndrome. Examination is highly recommended if the symptoms do not go away or interfere with daily activities.

Diagnosis Sjogren's Syndrome

Diagnosis of Sjögren's syndrome begins with a question and answer regarding the patient's symptoms and medical history, followed by a physical examination to confirm the symptoms experienced, such as dry eyes and mouth.

To confirm the diagnosis, the doctor will advise the patient to undergo further tests, such as:

  • Schimer
    test The Schimer test aims to determine the level of tears produced by the tear glands. This test is done by seeing how many tears wet the special paper in 5 minutes.
  • Slit lamp test The slit lamp
    test is used to see the surface of the eye more clearly. Doctors can also use eye drops so that damage to the cornea will be more easily seen.
  • Measurement of salivary levels
    This examination is carried out by weighing the level of saliva secreted by the patient into a container, in 5 minutes. Low salivary levels may indicate the patient has Sjögren's syndrome.
  • Blood
    tests Blood tests aim to look for antibodies that are specifically associated with Sjögren's syndrome, namely anti-Ro (SS-A) and anti-LA (SS-B). Blood tests can also be done to detect disorders of the liver or kidneys.
  • Biopsy
    Biopsy is done by taking a tissue sample on the inside of the patient's lips. The sample will then be examined to detect the presence of white blood cell clumps (lymphocytes) which are a sign of Sjögren's syndrome.
  • Scanning of the condition of the salivary glands.
    The scanning method used can be sialography (using X-rays) or scintigraphy (using special radioactive material). This examination aims to check the function of the salivary glands.

Treatment of Sjögren's Syndrome

There is no treatment method that can cure Sjögren's syndrome. However, doctors can take steps to relieve symptoms and prevent complications, according to the part of the body that is affected. Treatment methods that doctors can use for sufferers of Sjögren's syndrome include:

Administration of drugs  

Doctors can provide medicines to relieve the symptoms of Sjögren's syndrome that you are experiencing. Some of these drugs include:

  • Medicines to treat moderate to severe dry eyes, such as cyclosporin e or lifitegrast
  • Medications to increase saliva and tear production, such as pilocarpine and cevimeline
  • Medicines to help relieve symptoms of joint pain, such as non-steroidal anti-inflammatory drugs (NSAIDs) or joint pain medications
  • Antifungal drugs , to treat fungal infections in the mouth
  • Medicines to relieve symptoms of joint pain or stiffness, such as hydroxychloroquine
  • Medicines to suppress the immune system and help relieve symptoms of Sjögren's syndrome, such as methotrexate

Operation

In some cases, the doctor will perform a small operation to close the tear ducts. This procedure is done by inserting a plug made of collagen or silicone into the tear ducts. Therefore. there will be more tears stored in the eye.

Lifestyle changes

To help with treatment, patients can make independent efforts to deal with dry eye symptoms, such as:

  • Use eye drops or eye lubricant
  • Maintain room humidity
  • Avoid blowing winds that are too strong
  • Wear protective goggles when outdoors
  • Avoid reading, watching TV, or looking at the screen for too long
  • Clean the eyelids regularly
  • Do regular eye doctor checks
  • Avoid medications that can cause dry eyes

Meanwhile, to relieve dry mouth, patients can do the following:

  • Do not smoke
  • Drink a lot of water
  • Reduce consumption of alcoholic, caffeinated and carbonated drinks
  • Avoid consuming food and drinks that contain sugar
  • Maintain oral hygiene, especially by brushing your teeth regularly
  • Chew sugar-free gum or ice cubes if your mouth feels dry
  • Gargle with an antibacterial mouthwash
  • Use lip balm ( lip balm ) to prevent dry lips
  • Have your teeth and mouth checked regularly
  • Avoid medications that can trigger dry mouth

Symptoms of Sjögren's syndrome that occur in other parts of the body can also be relieved by doing the following:

  • Use moisturizing creams and avoid using soaps that contain perfume, to relieve symptoms of dry skin
  • Exercise regularly while consulting a therapist, to relieve joint and muscle pain
  • Taking pain relievers, to help relieve muscle and joint pain
  • Using lubricants when having sex or using vaginal moisturizers, to relieve vaginal dry symptoms

Complications of Sjögren's Syndrome

The following are some of the complications that can occur due to Sjögren's syndrome:

  • Eye damage
  • Blindness
  • Non-Hodgkin's lymphoma
  • Lupus rash and heart defects, in a fetus whose mother has Sjögren's syndrome
  • Lung infection
  • Bronchiectasis
  • Scar tissue in the lungs
  • Hypothyroidism
  • Irritable bowel syndrome
  • Vasculitis
  • Neuropati perifer
  • Cavities
  • Kidney disease, such as kidney stones or kidney inflammation
  • Fenomena Raynaud

Prevention of Sjögren's Syndrome

There is no way that can be done to prevent Sjögren's syndrome. However, there are several efforts that can be made to avoid autoimmune diseases, namely:

  • Do not smoke
  • Exercise regularly
  • Avoid exposure to toxic substances
  • Maintain a healthy diet
  • Limit consumption of processed foods

If you suffer from another autoimmune disease , carry out regular check-ups and undergo treatment given by your doctor to prevent Sjögren's syndrome from occurring.

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