Sjogren’s Syndrome (SS) is a debilitating autoimmune disorder characterized by the decreased production of saliva and tears in the salivary and lacrimal glands. Other components of the body that are commonly involved include the skin and the urogenital, respiratory, and gastrointestinal tracts.
Who Is At Risk for Sjogren’s Syndrome?
The reported prevalence of primary Sjogren’s Syndrome varies widely, from 0.05% to 4.8% of the population and frequency appears to increase with age. The diagnosis is usually made in midlife, but SS may occur at any age. The onset most often is insidious, and diagnosis may be delayed for a number of years. The disease is more common in females.
How Is Sjogren’s Syndrome Diagnosed?
The diagnosis can be made with a thorough history and examination. This can then be accompanied by some blood tests to assess for autoantibodies. Also, a Schirmer’s test can objectively assess for ocular dryness while a biopsy of the minor salivary glands can tell if SS is causing oral dryness. The criteria for classification of SS includes:
Ocular symptoms: a positive response to at least one:
- Have you had daily, persistent, troublesome dry eyes for more than three months?
- Do you have a recurrent sensation of sand or gravel in the eyes?
- Do you use tear substitutes more than three times a day?
Oral symptoms: a positive response to at least one:
- Have you had a daily feeling of dry mouth for more than three months?
- Have you had recurrent or persistently swollen salivary glands as an adult?
- Do you frequently drink liquids to aid in swallowing dry food?
Ocular signs: a positive result of at least one:
- Schirmer’s test (<5 mm in 5 minutes)
Rose Bengal score or other ocular dye score (>4) Histopathology: In minor salivary glands focal lymphocytic sialadenitis defined as more than 50 lymphocytes per 4 mm2 of glandular tissue.
Salivary gland involvement: a positive result of at least one
- Unstimulated whole salivary flow (<1.5 ml in 15 minutes)
- Parotid sialography showing punctuate, cavitary or destructive pattern without obstruction
- Salivary scintigraphy showing delayed uptake, reduced concentration or delayed excretion
Autoantibodies: presence in the serum of the following autoantibodies:
- Antibodies to SSA/Ro or SSB/La antigens, or both
For primary SS, three or four criteria must be met. For secondary SS, a patient must have an existing autoimmune disease plus two of the criteria.
How Does Sjogren’s Syndrome Develop?
The pathogenesis of SS is not currently known. However, it is thought that an as yet unidentified environmental agent (like a virus) may trigger a cascade of events in genetically susceptible hosts, resulting in the development of SS. Due to the striking predominance of SS in women, it has been postulated that hormonal factors have a role in disease pathogenesis. Genetic factors also may also play a role in the development of this disease.
What Are the Symptoms of Sjogren’s Syndrome?
Typical symptoms of Sjogren’s Syndrome include oral and ocular issues as well as signs of dryness, the presence of autoantibodies, and a positive labial salivary gland biopsy. Other manifestations can include cutaneous lesions, arthritis, respiratory symptoms, peripheral neuropathy, irritable bladder, and swollen lymph glands.
How Is Sjogren’s Syndrome Treated?
Treatment of dry eyes caused by Sjogren’s Syndrome includes tear replacement as well as ocular or systemic medications. Frequent dental care is important to prevent cavities in people with dry mouth. Sugar-free chewing gum or candies may be used to stimulate sufficient salivary secretions. If not, medications to increase salivary flow can be prescribed. Patient education on the manifestations and treatment of the disease minimizes complications.
Treatment for Sjogren’s Syndrome In Thousand Oaks, CA
If you have or think you may have Sjogren’s Syndrome, our talented team of medical professionals is here to help. Offering his patients the most up to date and efficacious treatments, Dr. Cohen at Cohen Medical Centers is ready to help you feel like yourself again. To learn more about Sjogren’s Syndrome treatment in Ventura County, simply call us at (805) 449-8781 to schedule your consultation; you may also fill out the form below, and a member of our helpful staff will get back to you.