Overview
When Sjogren's syndrome, the immune system begins to malfunction and attack healthy cells instead of fighting against bacteria and viruses. This is called in the broadest sense of an autoimmune disease. Leukocytes are usually protected from microbial attack glands located in all mucous membranes, but, primarily, eyes and mucous membranes of the mouth, which produce moisture. And if this happens, the production of saliva and tears is limited.
The most common symptoms of Sjogren's syndrome are dry eyes and mouth, burning, itching, or a feeling of roughness - a feeling of dust in the eyes, cotton in his mouth, which impairs swallowing and articulation.
When the disease is necessary to take medication throughout their lives, to eliminate the unpleasant symptoms. It is, basically, a lot of varieties of moisturizing eye drops. also can be assigned to other drugs that increase the amount of saliva in the mouth.
Causes
The exact cause of the syndrome is unknown. available genetic predisposition
to the disease, becoming a risk factor. A trigger in such a situation becomes a bacterial or viral invasion, which triggers an immune response, but due to the gene defect responsible for Sjögren's syndrome, leucocytes selected target healthy cells in the salivary and lacrimal glands.Classification
There are two types of Sjogren's syndrome: primary - symptoms of the disease are the first manifestations of it, and the secondary, when the symptoms manifested in patients with other rheumatic diseases, such as scleroderma, rheumatoid arthritis or systemic lupus erythematosus. Primary and secondary options syndrome occur with approximately the same frequency. It is sometimes difficult to accurate diagnosis. Sjogren's syndrome is quite common: in the UK, for example, there are about half a million patients. The most commonly affects women between the ages of 40 to 60 years, whereas only one patient in the 13 - man.
symptoms
Symptoms in Sjögren's syndrome varies from patient to patient. You can only have one or two symptoms, but in severe cases there may be a whole range.
Dry Sjogren's syndrome is manifested by:
- difficulty chewing or swallowing;
- inability to eat dry foods (crackers or cookies, adhering to the sky);
- cracks in the corners of the mouth, language;
- dryness and burning sensation in the nose and throat;
- dry cough;
- awakening at night because of the need for frequent drinking water;
- difficulty in a long conversation;
- hoarseness;
- high frequency caries and periodontal diseases;
- taste changes;
- difficulty in wearing dentures.
Dry eyes, which can cause:
- redness, itching or soreness eyes;
- roughness, roughness, burning sensation or feeling of sand in the eyes;
- sticking century before awakening;
- violation of visual acuity;
- hypersensitivity to bright light, which complicates reading, or watching TV;
- damage to the cornea (ulcerative keratitis) - the most serious ocular complication of Sjogren's syndrome.
As an autoimmune disease - a systemic disease process, even with Sjögren's syndrome may be affected mucosa of almost any organ.
Common symptoms are:
- fatigue, which can be severe enough to interfere with normal life;
- joint pain (arthralgia) and sometimes inflammation of the joints (arthritis);
- dryness and itching of the skin;
- skin lesions on the feet (purple) - M dots appearing in inflammation of blood vessels;
- occasionally appearing cyanosis of fingers and toes;
- pain during intercourse due to drying of the vaginal mucosa;
- dry cough, sometimes rolling in bronchitis or even pneumonia;
- heartburn.
They may also occur abdominal pain, bladder, sometimes affects the thyroid and pancreas. Some patients with Sjögren's syndrome may have an increased risk of developing cancer of the lymphatic tissue, known as lymphoma. This is a rare complication, but care must be taken to any early signs such as enlarged lymph nodes (in the neck, armpit or groin).
As a rule, most people sindromproyavlyaetsya mild functional disorders, but sometimes damage may be serious enough. As with any chronic disease, Sjogren's syndrome has a cyclic flow, and its symptoms can almost disappear completely and renewed again.
Diagnostics
Sometimes it is difficult to establish the diagnosis of Sjogren's because of the similarity of symptoms of this disease syndrome with other diseases. Diagnosed with Sjogren's disease, paying attention to the basic symptoms: itchy eyes, dry mouth, cracked lips, suddenly appeared cavities, pain, or stiffness of the joints. Possible to carry out some surveys to objectification disorders lacrimation and salivation. Known Schirmer test, wherein in the lower eyelid is placed a graduated strip of blotter paper, the level of moisture and which judge the degree slezoobrazovaniya disorders. Saliva production level was measured by collecting over a five-minute period of time ( "plevatelny" test).
Ultrasound diagnostics is used to diagnose the state of the salivary glands. Normally their homogeneous structure, and Sjögren's syndrome when they appear sealing zone. Magnetic resonance imaging (MRI) is used, if there is uncertainty about the diagnosis in suspected lymphoma or other anomalies.
Unfortunately, there is no single laboratory test, would allow us to accurately establish the diagnosis of Sjögren's syndrome. Often determined by elevated erythrocyte sedimentation rate, high level of C-reactive protein, other positive Revmoproby, but they so often in rheumatoid arthritis, lupus and many other diseases that their value seems questionable. Microscopic examination of the tissue of the salivary glands, taken by biopsy, may be valuable for assessing the risk of lymphoma in the future.
Identify the symptoms, prescribe treatment of Sjogren's syndrome should rheumatologist.
Treatment
In the treatment of Sjogren's syndrome all efforts aimed at eliminating or alleviating the most are bothered by symptoms and possible complications. Dry eye is usually eliminated by regular application of artificial tears during the day or gels used in the nighttime. Anti-inflammatory drops with antibiotics can be used to increase tear production.
Small but regular servings of drinking water, Chewing gum, using a saliva substitute can relieve dry mouth. Some patients are forced to take drugs that stimulate the production of saliva, such as pilocarpine.
Excessive dryness of mucous membranes may develop fungal infections in such cases used antifungal therapy (nystatin). Nasal sprays are used to moisten the nasal mucosa.
Medications that decrease gastric acid secretion (proton pump inhibitors, and H2-blockers) can reduce the symptoms of heartburn.
All patients You should receive regular dental care to detect cavities and prevent tooth loss that can occur as a complication of Sjogren's syndrome. Patients with dry eyes should regularly examined by an ophthalmologist for signs of corneal damage. Sometimes you may need serious medical treatment. Plaquenil, antimalarial drug used as lupus and rheumatoid arthritis, may be useful by reducing joint pain and cutaneous manifestations.
Patients with a rare but severe systemic symptoms (fever, rash, abdominal pain, lung or kidney) may require treatment with corticosteroids (prednisolone) And immunosuppressants (methotrexate, azathioprine, cyclophosphamide). nonsteroidal antiinflammatory drugs (NSAIDs) are widely used: ibuprofen, naproxen, Celecoxib, and others.
Tips Daily
A few tips can help ease the symptoms of the disease:
- More often blink several times a day to carry out minute sessions blinking.
- Add a computer monitor below eye level. This narrows the width of opening eyelids and accordingly reduce the evaporation of moisture.
- Maximum use humidifiers in residential and working areas.
- Protect your eyes from the wind.
- Do not smoke and stay away from the smoke.
- Do not use makeup.
- Do not wear contact lenses.
- Most drinking water in divided doses.
- Chew gum, suck on sour (lemon) Caramel.
- Avoid mouthwashes on alcohol.
- Brushing your teeth with fluorine-containing low-foam paste.
- Frequently disinfect dentures.
- Daily check the mouth for any redness and sores.
prevention
Such a disease, such as Sjogren's syndrome, are not subject to prevention, as well as other autoimmune diseases because their causes are unknown.
Forecast
Despite the prolonged, cyclical flow and the presence of a number of very unpleasant symptoms, the prognosis of Sjögren's syndrome is favorable for life, with strict observance of hygienic and therapeutic measures, the patient can almost forget that it is - Sjogren's syndrome, and to live a full life.
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