Sjogren's Syndrome

Sjogren syndrome patients usually have dry mouth and dry eye.
Sjogren syndrome usually affects glands producing moisture or water
They will have gritty feeling or sand like sensation in the eye and also unable to eat dry foods such as roti or biscuit without water because of dry mouth.
Production of saliva and tear is decreased in this disease.
Along with dry eye and dry mouth patient can have joint pain, easy fatigability, numbness and tingling in the feet.
Common age group of presentation is middle age group
Mostly people neglect the dry eye or dry mouth so Sjogren syndrome remain undiagnosed

Sjögren’s syndrome is an autoimmune disease in which body’s own immune system mostly attacks the moisture (eg-saliva and tear) producing glands.
It’s not exactly known why it happens but scientists are thinking role of infection and genetic background in pathogenesis of disease.
A lot of antibody production occur in this disease which mostly targets the moisture producing glands

Most common gland affected are tear and saliva producing glands
Dry eye-Develops gritty sensation in the eye and needs frequent use of eye drops for keeping it moist
Dry mouth- difficulty in swallowing of food especially dry foods such as roti or chapatti or biscuit, so requires frequent sips of water in between food intake. Dry mouth leads to high risk of dental caries
SS can also affect other glands such as those in the skin and the vagina
Sometime can have bilateral parotid gland swollen
Along with dry eye and dry mouth Fatigue is also a common symptom in patient with sjogren syndrome
Most patients with sjogren syndrome are only having mild symptoms of dry eye ,dry mouth and fatigue in all of the time.
Only a few will have joint,lung ,kidney or nervous system involvement.

Joint symptoms-Pain, swelling and stiffness of the joint mostly in the early morning.
Lung symptoms-Interstitial lung disease (ILD).They will have dry cough and breathlessness on exertion
Nervous system-neuropathy symptoms such as tingling or burning sensation and numbness in the hand and foot

Sjögren’s syndrome can be tricky to diagnose because of its range of symptoms and people mostly neglect about the dry eye and dry mouth
If you have dry eye or dry mouth then consult rheumatologist who knows about the disease
Look for any gland enlargement such as parotid gland swelling

ANA- The anti nuclear antibody (ANA) is the first test to be done if sjogren syndrome is suspected. If it comes negative then less chance of having sjogren syndrome.If it comes positive then more tests should be done to confirm the diagnosis.

Extractable Nuclear Antigen (ENA) Panel – By this test presence of several antibodies such as Anti Ro,Anti La,Anti Rnp,Anti Smith can be detected.

Rheumatoid factor (RF)- Some patients with Sjogren syndrome can have RF positive
Common test-CBC,ESR and CRP done to look for any evidence of inflammation in the body
Urine RE/ME-Look for any evidence of proteinuria, acidosis
Biopsy of salivary gland: Sometime if any doubt then a very small tissue sample from minor salivary gland (taken from lip) need to be examined for any inflammation

Sjögren’s Syndrome (SS) has no effect on fertility.
The chances of getting pregnant for people with SS are the same as with people that don’t have it.
It is important for people with SS who want to become pregnant to discuss their medications with their doctor and do a pre-pregnancy plan.