Sjogren's syndrome - what is it? This is the name of a rather dangerous disease that is common among women over 40 years old. The clinical picture of the pathology is extremely extensive, the disease affects a large number of different organs and systems. You can get rid of the disease in the early stages. During therapy, certain medications are used.
Sjogren's syndrome can significantly reduce a person's quality of life, so treatment should begin as early as possible. In addition, modern diagnostics allows you to easily determine the presence of the disease and the features of its course. The treatment of the disease should be handled by a rheumatologist.
Sjogren's syndrome - what kind of disease is it? In terms of its prevalence, this defect ranks second among rheumatic disorders of an autoimmune nature. About 4 million people in the United States suffer from this disease. Most often, adult women undergo pathology after menopause.
Let's try to figure out what are the causes, symptoms, treatment and prevention of Sjögren's syndrome. About this shouldeveryone should know, because anyone can experience this disease.
Sjogren's syndrome - what is it
A serious autoimmune disease, which is accompanied by malfunctions of the lacrimal and salivary glands. With this syndrome, their activity decreases, which gradually leads to increased dryness of the skin and mucous membranes, as well as a decrease in the production of essential enzymes.
The first manifestations of the disease were described in 1965 by the Swedish ophthalmologist Sjögren, after whom it got its name. This pathology can develop independently or against the background of other diseases. In addition, it itself can cause other abnormalities in the body.
According to its course, the disease is divided into two types:
- Chronic form. It is characterized by damage to the glands, develops almost imperceptibly to humans. As the disease progresses, the patient begins to feel an unusual dry mouth, while the salivary glands stop working fully and increase in size.
- Subacute course of Sjögren's syndrome. What it is? A more dangerous form of the disease, its clinical picture is much more extensive. At an early stage, an inflammatory process develops, the body temperature rises. Gradually, the disease leads to damage to the joints, and then other important systems are involved in the pathological process.
Sjögren's syndrome is an autoimmune disease. In other words, pathology occurs due to deviations in the activity of immunity. As a result of various failures, the body begins to accept its owncells for alien ones, against the background of which there is an active production of special antibodies. Gradually, inflammation develops, which provokes a decrease in the function of the lacrimal and salivary glands.
Causes of disease
To say exactly why autoimmune pathologies appear, doctors still cannot. So where does Sjögren's syndrome come from remains a mystery not only for patients, but also for doctors.
Only one thing is known for sure: immunological, genetic, hormonal and even some external conditions take part in the process of the origin of the pathology. Most often, various viruses, such as herpes, Epstein-Barr, cytomegalovirus, or serious diseases such as rheumatoid arthritis, systemic scleroderma, polymyositis, lupus erythematosus, become provocateurs of the development of the disease.
If you notice excessive dryness in the nose and crusts that cause discomfort, difficulty swallowing solid foods, no tears when peeling onions, you definitely need to see a rheumatologist.
There are several major risk factors:
- women over 40;
- presence of chronic infections in the body;
- diabetes mellitus;
- metabolic deviations of the digestive tract;
- regular exposure to stress;
- smoking;
- use of cytostatics, antidepressants, anti-inflammatory and antibacterial drugs;
- genetic predisposition.
Secondary and primary syndrome
There are two varieties of the disease. But in both primary and secondary Sjögren's syndrome, patients complain of the same problems, and the cause of the pathology is the same. What then is the difference? The primary type is an independent disease. But the secondary syndrome is always associated with other pathologies, for example, lupus erythematosus, diabetes mellitus or rheumatoid arthritis.
The mechanism of the development of the disease is an active attack by leukocytes of the lacrimal and salivary glands, as well as other tissues. It is this anomaly that results in dryness and crusts in the nose, dry eye syndrome, as well as excessive dryness of the skin and even the vagina.
Both secondary and primary Sjögren's syndrome are extremely complex, severe pathologies. Approximately 90% of all cases of the disease are women. With regard to the overall occurrence, Sjögren's syndrome is diagnosed in approximately 8% of the total world population. Of these, approximately 20-25% is a secondary form of the disease. Which is characterized by an autoimmune systemic lesion of the connective tissue. The numbers are pretty scary.
The mucosal injury itself causes a lot of discomfort to patients, but in addition, it can lead to numerous complications that are difficult to treat.
Clinical picture
All symptoms of Sjögren's syndrome are divided into two groups:
- systemic (extra-glandular) - manifestations that are not characteristic of this disease;
- glandular - the glands are damaged, as a result of which their work worsens,which leads to the appearance of the corresponding signs.
One of the main symptoms of the disease is excessive dryness of the mucous membranes with nervous and emotional overstrain. The progression of the pathology is characterized by an increase in symptoms. Dryness does not go away, a person has to constantly drink solid foods, he feels the need to moisturize the oral cavity and use special moisturizing preparations for the eyes.
Glandular disease symptoms
Keroconjunctivitis is one of the main symptoms of Sjögren's syndrome. It is accompanied by itching and redness of the eyelids, accumulation of fluid in the corners of the eyes. The patient's visual acuity gradually decreases, he experiences severe discomfort in bright light. In addition, there is profuse lacrimation, clouding of the cornea, and trophic ulcers form in some places. This is the reason for dry eyes. Perforation and purulent conjunctivitis develop due to the penetration of the shell of staphylococcus aureus.
Chronic parotitis is the second most common symptom of Sjögren's syndrome. It is characterized by damage to the salivary glands, an increase in the size of the lymph nodes, the occurrence of stomatitis and caries. At the next stage, dryness in the throat and nose appears, an increase in the salivary glands. The patient has to constantly monitor the moistening of the mouth. Symptoms are exacerbated at times with the use of sweets.
About half of the cases, the disease is accompanied by regular exacerbations. As it progresses, an increase in the salivary glands is observed, due towhich may even change facial features. Dry tongue and oral mucosa turn red over time, in some cases damage is noted, the consistency of saliva changes - it becomes too viscous and thick, produced in minimal quantities.
Among other things, the pathology is accompanied by a number of accompanying symptoms:
- Hoarse voice, inflammation of the mucous membrane of the larynx, hearing loss on the background of otitis media. Women develop swelling, atrophy and dryness of the vagina. Over time, because of this, colpitis appears, which is characterized by a decrease in libido, soreness, itching and burning in the reproductive organs.
- An equally common symptom of the disease is a decrease in sweating, excessive dryness of the skin. In about 30% of cases, there is a lesion of the sweat glands located in the armpits, vulva, pubis.
- Approximately 80% of cases involve the digestive tract. Due to the reduced secretion of the necessary enzymes, sensitivity to dairy and fatty products increases several times, deviations in the work of the stomach and intestines are noted.
Systemic signs of pathology
Among other things, Sjögren's syndrome leads to extraglandular symptoms:
- Bone pain. The only way to determine the cause is with x-rays. In about 60% of cases, the disease is accompanied by pain, stiffness of movements, which manifests itself most clearly in the morning. Usually, in the pathological processsmall bones are involved, but large joints remain intact. In 10% of patients, there is intense pain and slight muscle weakness, sometimes polymyositis develops.
- Tracheobronchitis. Appear in half of the cases. Against the background of this disease, the patient has a slight cough, shortness of breath becomes more frequent. Pulmonary fibrosis, vasculitis, or pleurisy may develop. Small rashes appear on the skin, consisting of spots and dots, ulcers, slight necrosis are formed. The patient feels itching, burning, body temperature rises.
- Polyneuropathy. This condition is characterized by a complete loss or decrease in the sensitivity of the skin on the legs and arms, sometimes brain lesions appear. During the diagnosis, the patient may detect abnormalities in the functioning of the thyroid gland, a tendency to allergic reactions to certain foods, drugs and chemicals.
Diagnosis
In fact, Sjögren's syndrome is not dangerous for human life, but it can significantly reduce its quality, causing disability. You can independently detect the disease by a dry tongue and the absence of tears while cutting onions. If such signs occur, it is necessary to contact a rheumatologist for a full examination, in which oculists and dentists will also participate. In addition, the patient may need to consult a neurologist, gastroenterologist and orthopedist.
Due to the similarity of the symptoms of Sjögren's syndrome with manifestations of other diseases to confirm a suspected diagnosisa wide range of research is required. The doctor may suspect the presence of the disease when the following signs appear:
- if a person is forced to use eye drops all the time;
- with swelling of the salivary glands;
- if you feel persistent eye irritation;
- drink solid foods if necessary;
- dryness does not disappear within three months.
To determine the pathology and assess its severity, a specialist may prescribe several examinations:
- blood test for the presence of antinuclear bodies, which are markers of the inflammatory process;
- Schirmer strip test - involves placing a narrow strip of special paper under the lower eyelid, which should get wet in just 5 minutes;
- salivary gland biopsy;
- MRI and ultrasound to visualize inflamed areas;
- complete blood count;
- examination of the fundus with a special lamp;
- staining the cornea with a pink solution;
- sialometry - necessary to assess the work of the salivary glands.
Only after a complete diagnosis, the doctor will be able to prescribe the appropriate treatment tactics.
Features of therapy
In fact, Sjögren's syndrome is a very serious but not fatal problem. If the symptoms of the disease are detected in time and treated, the risk of complications will be minimal. For patients, only one thing is important - to remember the importance of a he althy lifestyle. That's the only waystrengthen immunity, which will prevent the pathological process from developing further.
Today, Sjögren's syndrome is successfully treated, but it is impossible to completely get rid of the disease. So after the diagnosis is made, the patient is expected to receive only symptomatic therapy.
Complex treatment makes it possible to minimize the manifestations of the disease and prevent the occurrence of various complications. Self-medication in this case is strictly prohibited, since such a decision may lead to an aggravation of the clinical picture.
In the early stages, doctors recommend taking immunosuppressants and hormones. To stop inflammation, immunosuppressors and glucocorticosteroids are used. These drugs slow down the immune system and reduce its attacks on its own organs. If the patient's immune system is severely weakened, the doctor may prescribe antibiotics to prevent secondary infections.
Clinical guidelines for Sjögren's syndrome
The treatment of this disease provides for the maximum relief of the patient's condition and the fight against autoimmune failure:
- With reduced saliva production, "Pilocarpine" and its analogues are used. In addition, patients are encouraged to drink as much liquid as possible.
- In case of dry eyes, "Artificial tear" drops are used. The price of this drug is considered affordable. Preparations based on hypromellose are considered no less effective, and in the evenings it is recommended to lay therapeutic ointments under the eyelids. According to reviews, the best effectpossess drops "Artificial tear". The price of the drug ranges from 120-210 rubles. They provide quick relief for dry eyes and provide long lasting results.
- During exacerbations, take antipyretics.
- If the patient suffers from pain associated with pathologies of the musculoskeletal system or myalgia, non-steroidal anti-inflammatory drugs are used.
- Applications based on "Heparin", "Hydrocortisone" and "Dimexide" effectively fight inflammation of the glands.
- For dryness of the bronchi and trachea, it is recommended to use Bromhexine.
- Rinses are used to eliminate dry mouth.
- Dry eye syndrome is eliminated with saline and "Hemodez". But before use, it is better to consult a doctor.
- What to do with vaginal dryness? Doctors recommend using special lubricants and taking antifungal drugs.
- Often, dryness in the mouth leads to caries. To prevent the problem, doctors advise to constantly monitor hygiene, visit the dentist regularly and use pastes containing fluoride.
- Sometimes doctors also recommend reducing physical activity and changing your diet. If there is a stable remission, alternative means are allowed.
Most often, doctors prescribe several effective drugs:
- "Prednisolone" - glucocorticoid;
- "Solcoseryl" and "Parmidin" - angioprotectors;
- "Splenin" - immunomodulator;
- "Heparin" - anticoagulant;
- "Cyclophosphamide", "Azathioprine", "Chlorbutin" - cytostatics;
- "Trasilol", "Kontrykal" - stop the production of some enzymes.
Principles of nutrition
There is no specific diet for Sjögren's syndrome, but there are certain nutritional principles that help minimize unpleasant symptoms. In addition, if you take into account the he alth of the oral cavity, then just the right diet allows you to protect your teeth from aggressive influences.
Doctors advise first of all to give up alcohol. In addition, foods containing large amounts of fruit acids should be excluded from the daily menu.
The main diet of a person diagnosed with Sjögren's syndrome should consist of liquid meals. Doctors advise to complement treats with a variety of sauces, juicy fruits and vegetables, such as tomatoes and cucumbers.
The most suitable meal option is a menu with a lot of fresh products and a minimum of sweets and saturated fats.
Probable Consequences
Patients who do not treat the disease may experience a number of unpleasant complications:
- wrinkling of the tongue, difficulty swallowing;
- complete disappearance of saliva;
- keratinization of the skin on the inside of the cheeks;
- secondary infection;
- cracking and loss of teeth, caries;
- various causes of dry eyes can lead to poor vision;
- fungal infections - stomatitis, candidiasis;
- pathology of the chest - pleurisy, bronchitis, pneumonia, respiratory failure;
- renal failure and other kidney disorders;
- numbness or loss of mobility of arms and legs;
- lymphoma.
People diagnosed with Sjögren's syndrome often develop malignant tumors. Most often, such patients encounter lymphosarcoma of the salivary glands.
Relapse Prevention
To prevent further development and exacerbation of the clinical picture in Sjögren's syndrome, it is recommended:
- reduce stress on vocal cords and eyes;
- avoid stressful situations;
- constantly take prescribed medications;
- avoid prolonged sun exposure;
- refuse vaccination;
- treat comorbidities;
- stick to a he althy diet.
Lack of timely therapy and neglect of the doctor's instructions is fraught with loss of working capacity, disability and damage to various organs.
Now you know everything about what are the causes, symptoms, treatment and prevention of Sjögren's syndrome. As you can see, it's pretty serious.disease, but not life-threatening. And if you follow all the doctor's recommendations, you can completely forget about all the discomfort that the symptoms of the pathology provoke.
