What is The Sjögren's Syndrome?
Sjögren's Syndrome is an autoimmune (self-made) disease that causes dry eye, dry mouth and dry nose. In autoimmune diseases, the body's defense system functions against it. It is the body's natural defense against immune system antigens (foreign bodies such as bacteria and viruses). Sometimes the immune system does not work properly, and it loses the ability to distinguish between its own body cells and antigens. Instead of fighting antigens, the immune system mistakenly fights against its own body cells. This event is considered an autoimmune event.
Sjögren can occur in two forms: primary and secondary.
Primary Sjögren Syndrome occurs on its own and is not related to other diseases.
Secondary Sjögren Syndrome occurs with some types of inflammatory rheumatic diseases such as rheumatoid arthritis, lupus, and polymyositis.Sjogren's Syndrome; Although it is relatively rare in people under the age of 20, it can affect people of all ages and races. 90% of the patients are women. The tendency to develop Sjögren Syndrome increases in the event of a disease in one family.
What Happens in Sjögren's Syndrome?
In Sjögren's Syndrome, a white blood cell called lymphocyte occupies glands, such as tear and salivary glands, and glands in the vagina. Lymphocytes can damage these glands and prevent them from producing secretions. As a result, there is dryness in the mouth, eyes, and vagina. Sjögren's Syndrome can also cause problems in other parts of the body. It can cause inflammation in the lungs, kidneys, liver, nerves, thyroid gland, joint, and brain.
Symptoms of Sjögren's Syndrome?
Sjögren's Syndrome affects everyone differently, and its findings are of different severity. Frequent findings are listed below.
Dry mouth
The mouth normally contains saliva and helps to chew and swallow. Patients with Sjogren's Syndrome produce less saliva than usual. This makes it difficult to chew, swallow and speak. This can also reduce the sense of taste.
Dry eyes
The eyes feel dry, sandy. There may be burning and redness in the eyes. Excess mucus (burr) may accumulate around the eyes while sleeping. Your eyes may be more sensitive to sunlight. If not treated well, Sjögren's Syndrome can lead to blind spots in the eyes and corneal ulcer (wound on the outer part of the eyeball). Rarely, this can lead to vision loss.
Swollen salivary glands
Three pairs of large glands produce saliva. These are located under the tongue, under the cheek in front of the ears and behind the mouth. These glands may appear swollen or felt. It can be mixed with mumps. Sometimes it can become sensitive and accompany fever. In Sjögren's Syndrome, swollen glands are observed in approximately half of the patients.
Dental caries
This is a general problem caused by dry mouth. Saliva contains bactericidal substances (enzymes) and these substances fight bacteria. Thus, it acts as a protective against tooth decay. When saliva is reduced, less enzymes are produced. Because of this, teeth are more easily bruised.
Fungal infection in the mouth
Most people with dry mouth have burning and redness in the mouth. This complaint is created by a small fungus called Candida in the mouth.
Dry nose, throat and lungs
Dryness; causes the throat to have a dry and annoying feeling. Dry cough can cause hoarseness, decreased sense of smell and nosebleeds. Dryness can also lead to pneumonia, bronchitis and ear problems.
Dryness of the vagina
Sjögren Syndrome can cause pain and irritation in the vagina due to dryness. It causes sexual intercourse to become painful for the woman.
Tiredness
It is a frequent finding of Sjögren's Syndrome. It can occur due to the disease itself or it can develop as a result of physical and emotional stress caused by having chronic disease.
Other issues
Other problems with Sjogren's Syndrome; inflamed and painful joints, muscle weakness, dry skin, rashes, constipation, feeling of numbness due to inflammation in the nerves, tingling and swollen lymph nodes. These show the importance of the continuation of doctor's follow-ups.
Complaints of Patients With Sjogren's Syndrome
The following symptoms and complaints may occur in patients:
• Dryness, burning, itching, and excessive sensitivity to light develop in the eyes. The patient describes it as, "As if sand is in my eye."
• There may be weakness and joint pain
• Sensitivity of cold and color changes such as whitening in the limbs may occur.
• Swelling of the salivary glands, deterioration in taste and smell can be observed.
• Dryness may occur in the nose, skin and female genital organs. Sometimes, a type of lymph node cancer called "lymphoma" can develop in patients.
• There may be weakness and joint pain
• Sensitivity of cold and color changes such as whitening in the limbs may occur.
• Swelling of the salivary glands, deterioration in taste and smell can be observed.
• Dryness may occur in the nose, skin and female genital organs. Sometimes, a type of lymph node cancer called "lymphoma" can develop in patients.
Causes of Sjögren's Syndrome?
The reason is unknown. There is evidence that genetics, viral infections and hormones are effective. The causes of Sjögren's syndrome are not fully known. However, there are environmental factors added to genetic susceptibility, namely viruses, hormones, or research showing that all of them are effective. Nine out of ten patients with Sjogren's syndrome are women. Although the average age of occurrence is 40-50 years old, it can also be seen in children, adolescence and young adults. It is not known what caused Sjögren's Syndrome. However, as with all autoimmune diseases, the immune system responds abnormally to the interaction of environmental factors such as infection and medication, as well as the genetic predisposition of the person. The common feature of "autoimmune" diseases is that the immune system, which is originally tasked with defending the body, begins to hurt itself. Although the diseases occurring in these conditions give symptoms depending on the type of body structures involved; however, before considering Sjögren Syndrome, it is necessary to make sure that there are no more common causes such as diabetes, otolaryngology and medications used.
Drying in the eyes and mouth can be a warning for your health!
Sjögren's syndrome (pronounced “Sgrengren's syndrome) (dryness syndrome) is a disease that causes dry mouth and dry eye findings. It is one of the diseases caused by the immune system, which is responsible for protecting the body against damages such as infection from outside, when it does not work properly and damages its organs. Firstly, germ-free inflammation (inflammation) develops in the glands producing salivary glands, tear glands, and pancreas. As a result, saliva and tear production decreases and symptoms of internal organs appear.
What are the findings?
In Sjögren's Ssndrome, suddenly dry mouth and eyes, burning in the eyes, stinging, itching, sand stinging sensation, feeling of something missing, difficulty in swallowing food, needing to drink water while talking, noise in the voice, throat, tooth decay and / or sudden loss of teeth. there may be an increase. Also; dry skin, nose may also develop. There may be occasional short-term swelling on the cheeks, in front of and below the ears, under the chin.
In addition to lung infections such as bronchitis, pneumonia, sinus and ear infections may also develop. In addition, as a result of the damage caused by the fire in the lung, shrinkage of the lung tissue (fibrosis) may occur, it may decrease the effort capacity and shortness of breath.
Some patients with Sjögren's syndrome may develop a small red rash primarily on the legs as a result of a fire developing on the walls of small vessels.Some patients with Sjögren's syndrome may experience bleeding and / or protein excretion, and some may have kidney inflammation, which can lead to kidney failure.
In patients with Sjögren's syndrome, abnormal lymphocytes may proliferate poorly and develop lymph node cancer (lymphoma).In this disease, other organs of the body such as the liver, pancreas, stomach and brain can be involved, as well as in the lungs, kidneys, blood vessels. Often there may be exhaustion, weakness, joint pain, morning stiffness that may impair quality of life.
After all, the symptoms of Sjögren's syndrome are variable and numerous. Dry eye is an important finding. However, the symptoms and histories of two patients with the same diagnosis can be very different from each other. Sjögren Syndrome is a disease that conforms to the classical definition of “there is no disease, there is a patient”.Diagnosis is not easy; Because the symptoms and symptoms of Sjögren's syndrome may resemble many other diseases such as other rheumatological diseases, chronic fatigue syndrome, fibromyalgia, multiple sclerosis. Different symptoms of the disease may be noticed by different specialists whom the person applies, but it may take time to reach the whole. In addition, Sjögren's syndrome is not the only disease that causes dry eyes, mouth or other organs. Medicines used to treat diabetes, hypertension, allergies, depression or colds or gastrointestinal tract can also cause dry mouth and eyes.
Sjogren's Syndrome Treatment
There is no cure for Sjögren Syndrome. However, the approaches applied to early diagnosis and daily life to reduce the effect of the disease are important. Sjögren's syndrome may not be life threatening, but it may impair quality of life. Regular use of moisturizers such as artificial tears, saliva and medical treatment and following the recommendations will prevent the emergence of new problems and will ensure the enjoyment of life. A comfortable treatment can lead a comfortable life.
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul
Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Websites: www.muratenoz.com / www.ent-istanbul.com
Appointment Phone: +90 212 561 00 52
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