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Sjgrens syndrome

SUBMMITED BY : MASA, REZZLE S. III-A GROUP-5

Sjgren's syndrome

( It is named after Swedish ophthalmologist Henrik Sjgre (18991986) who first described it )

also known as Mikulicz disease and Sicca syndrome is a systemic autoimmune disease in which immune cells attack and destroy the exocrine glands that produce tears and saliva.

CLASSIFICATIONS

Primary Sjgrens syndrome the disease by itself, not associated with any other illness Secondary Sjgrens syndrome disease that develops in the presence of another autoimmune disease such as rheumatoid arthritis, systemic lupus erythematosus or vasculitis

CAUSES Specific cause of Sjogren's syndrome is not clearly known, although there is growing scientific support for genetic factors. Sjogren's syndrome is more common in the families that have members with other autoimmune disorders, such as systemic lupus erythematosus, autoimmune thyroid disease, or juvenile diabetes. The syndrome more commonly affects females. SIGNS AND SYMPTOMS Extremely dry eyes causing: --feeling of grit or sand in the eyes --Burning --Redness Extremely dry mouth and throat causing: --difficulty chewing and swallowing --decreased sense of taste --difficulty speaking --increase in dental cavities --dry cough or hoarseness Enlarged parotid glands (located at the angle of jaw) and sometimes infection of the parotid glands Excessive fatigue

Aches and pains in muscles and jointsLess common features of Sjgrens syndrome are: Irritation of the nerves in the arms, hands, legs or feet (neuropathy) Thyroid gland abnormalities Skin rashes Memory loss or confusion Feeling of numbness or tingling Gastrointestinal problems Inflammation of the lungs, kidneys, liver or pancreas Cancer of the lymphatic tissue (occurs in up to 5% of patients with the disease)

Who is affected by the disease?


More than one million people in the United States have Sjgrens syndrome. Over 90% of people affected by Sjgrens syndrome are women. The disease can affect people of any race or age. How is primary Sjgrens syndrome diagnosed? The diagnosis of Sjgrens syndrome is based on several factors, including: Presence of dry eyes and mouth --Dry eyes can be detected by an ophthalmologist (eye doctor) by measuring tear production or carefully examining the cornea (clear part of the eye). Certain laboratory tests also suggest that dry eyes and mouth are caused by autoimmune mechanisms --Examples include the presence of autoantibodies in the blood, known as antiSSA or anti-SSB (also known as anti-Ro or anti-La). Biopsy of the inner lip (performed in some cases to prove the diagnosis of primary Sjgrens syndrome). The biopsy may show the inflammation that is damaging the salivary glands. How is secondary Sjgrens syndrome diagnosed? Secondary Sjgrens syndrome is generally diagnosed when someone with an established autoimmune disease such as rheumatoid arthritis or systemic lupus erythematosus develops extreme dryness of the eyes and mouth. This diagnosis only rarely requires a lip biopsy. Can other problems mimic Sjgrens syndrome? The use of certain medications such as tricyclic anti-depressants and antihistamines can mimic the symptoms of Sjgrens syndrome. Radiation treatments to the head and neck and other autoimmune disorders can also cause severely dry eyes and mouth. How is Sjgrens syndrome treated?

There is no cure for Sjgrens syndrome, but it can be treated and controlled. The goals of treatment are to decrease discomfort and reduce the harmful effects of dryness. The type of treatment prescribed will be tailored to each patients symptoms and needs. Good oral hygiene Good mouth care may not prevent a dry mouth, but it helps prevent infection. Toothpastes and oral gels are available for people with dry mouth symptoms. These products contain low doses of peroxide (high amounts could make dryness worse). These products may also have antibacterial action to reduce the severity of dental cavities over a long period of time. Increasing eye moisture Dry eyes are mainly treated with the use of artificial tears, and a wide variety of products are available. Artificial tears must be used regularly and more often in dry environmental conditions such as on airplanes, in air-conditioned buildings and on windy days. While artificial tears are helpful, they often do not last long enough. Thicker preparations are available that last longer. These are often used at bedtime because they can sometimes cause blurry vision. Surgery to slow the disappearance of tears is another treatment option when artificial tears are not sufficient. Medications Medications that tend to deplete body fluids should be avoided. Mild pain-relieving medications (analgesics) including acetaminophen (such as Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs, such as Motrin and Aleve) can reduce muscle or joint pain. In some patients, the anti-rheumatic drug, hydroxychloroquine, has been beneficial in decreasing pain and salivary gland swelling. For patients with generalized symptoms, particularly when the disease affects internal organs (including the gastrointestinal system, kidneys or nervous system), high doses of immunosuppressive medications may be necessary. These include medicines such as prednisone (a steroid) and rarely, chemotherapy-type medications. Balance of rest and exercise Guided exercise programs can help patients overcome fatigue, maintain flexibility and overcome joint and muscle pain.

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