What is Sjogren's syndrome?
Sjogren's syndrome is a chronic systemic autoimmune disease in which the body's immune system mistakenly attacks its own exocrine glands, predominantly the salivary and lacrimal glands. This leads to their inflammation and a gradual impairment of secretory function. The condition can develop as an independent disorder (primary Sjogren's syndrome) or accompany other rheumatological diseases, such as rheumatoid arthritis or systemic lupus erythematosus (secondary Sjogren's syndrome).
In medical practice, patients with this diagnosis often encounter multisystem manifestations requiring an interdisciplinary approach. Although classical manifestations involve the exocrine glands, the systemic nature of the pathology can cause changes in various organs and tissues [1], [4].
Main symptoms of the disease
The clinical presentation of Sjogren's syndrome is diverse; however, the key and most recognizable signs are glandular manifestations:
- Dry mouth (xerostomia): the patient experiences a constant lack of saliva, difficulty chewing and swallowing dry food, altered taste sensations, and a burning sensation on the tongue.
- Dry eyes (keratoconjunctivitis sicca): a gritty or "sandy" sensation in the eyes, burning, redness, and increased sensitivity to light due to insufficient tear production.
- Salivary gland enlargement: periodic or constant painless enlargement of the parotid salivary glands.
- Extraglandular manifestations: general weakness, rapid fatigue, joint pain (arthralgia), dryness of the skin and mucous membranes in other locations.
In some cases, similar gastrointestinal symptoms or general malaise require differential diagnosis with other conditions, excluding acute inflammatory processes of the gastrointestinal tract or nutritional deficiencies [1], [5], [6].
Modern diagnostic methods
Diagnosing Sjogren's syndrome in rheumatology requires a comprehensive approach, as its symptoms can mimic other pathologies. A rheumatologist evaluates the patient's complaints, performs a physical examination, and prescribes a number of specific tests:
- Specific laboratory tests for autoantibodies (anti-Ro/SSA and anti-La/SSB antibodies).
- Instrumental assessment of saliva and tear secretion (Schirmer's test to evaluate tear production, sialometry).
- Biopsy of the minor salivary glands of the oral mucosa to detect characteristic lymphocytic infiltration.
- Additional imaging and endoscopic examinations in the presence of concurrent systemic complaints [1], [3].
Modern approaches to treatment also take into account concomitant gastroenterological or neurological risks that may arise in patients against the background of chronic inflammatory processes [2], [5].
Treatment and relief of dryness symptoms
The therapeutic strategy for Sjogren's syndrome aims to reduce the severity of symptoms, improve the patient's quality of life, and prevent potential complications. Since it is not yet possible to completely eliminate the autoimmune process, treatment is symptomatic and pathogenetic in nature:
- Using artificial tears and moisturizing gels to protect the corneal epithelium.
- Using saliva substitutes, sprays, and salivation stimulants to combat xerostomia.
- Thorough oral hygiene to prevent dental caries and fungal infections, the risk of which increases due to a lack of saliva.
- Systemic therapy (anti-inflammatory drugs, immunosuppressants, and biological agents) for pronounced systemic manifestations and internal organ involvement.
Prevention and patient recommendations
Patients with Sjogren's syndrome are advised to undergo regular monitoring by a rheumatologist, dentist, and ophthalmologist. It is important to avoid factors that exacerbate dryness of the mucous membranes: staying in rooms with dry air, smoking, and taking medications that can reduce saliva and tear secretion. Timely diagnosis and adequate supportive therapy allow for effective disease control and maintenance of a high quality of life.
Sources
- 1. Case Report: Scar-Like Alterations of the Gastric Mucosa Observed Under Endoscopy in Collagenous Gastritis. PubMed
- 2. Gerstmann Syndrome as the Sole Clinical Manifestation of Ischemic Stroke Secondary to Atrial Fibrillation. PubMed
- 3. Spectrum of Upper Gastrointestinal Endoscopic Findings in Patients With End-Stage Renal Disease Undergoing Maintenance Hemodialysis. PubMed
- 4. A Decade With Sheehan's Syndrome: A Case Report and Personal Experience. PubMed
- 5. Treatment of gastritis and gastroparesis symptoms with erector spinae plane block in the emergency department. PubMed
Disclaimer: The information presented in this article is for informational purposes only and does not replace an in-person consultation with a rheumatologist. If disease symptoms appear, consult a specialist.