Sjogren's syndrome is an autoimmune disease that causes systemic damage to connective tissues. From the pathological process, the exocrine glands - the salivary and tear glands - suffer most of all. In most cases, the disease carries a chronic progressive course.
Sjogren's Syndrome - what is this disease?
On the complex of symptoms of dry syndrome for the first time the attention was paid by Swedish ophthalmologist Shegren a little less than a hundred years ago. He found a large number of his patients who came to him with complaints of dryness in the eyes, a couple of other identical symptoms: chronic inflammation of the joints and xerostomia - dryness of the oral mucosa. Observation interested other doctors and scientists. It turned out that this pathology is common and to fight it requires a specific treatment.
Sjogren's syndrome - what is it? This chronic autoimmune disease appears against the background of failures in the immune system. The organism takes its own cells for foreign cells and begins to actively develop antibodies to them. Against this background, the inflammatory process develops, which leads to a decrease in the function of the glands of external secretion - usually salivary and lacrimal.
Sjogren's Syndrome - Causes
To say unequivocally why autoimmune diseases develop, medicine can not yet. Therefore, where the dry syndrome of Sjogren comes from is a mystery. It is known that genetic, immunological, hormonal and some external factors participate in the development of the disease. In most cases, viruses such as cytomegalovirus, Epstein-Barr, herpes, or diseases such as polymyositis, systemic scleroderma, lupus erythematosus, rheumatoid arthritis become the impetus to the development of the disease.
Primary Sjogren's Syndrome
There are two main types of illness. But they are about the same. Drying of mucous membranes in both cases develops due to lymphocytic infiltration of exocrine glands along the gastrointestinal tract and respiratory tract. If the disease develops as an independent disease and nothing preceded its appearance, then this is the primary disease of Sjogren.
Secondary Sjogren's Syndrome
As practice shows, in some cases, the disease occurs against the background of other diagnoses. According to statistics, a secondary dry syndrome is found in 20 - 25% of patients. It is put when the disease meets the criteria of such problems as rheumatoid arthritis, dermatomyositis, scleroderma and other associated with lesions of connective tissues.
Sjogren's syndrome - symptoms
All manifestations of the disease are divided into glandular and extra-iron. The fact that Sjogren's syndrome has spread to the lacrimal glands can be understood by the sensation of burning, "sand" in the eyes. Many complain of a severe itching eyelid. Often eyes turn red, and in the corners of them accumulates a viscous whitish substance. As the disease progresses, photophobia develops, the eye slits noticeably narrow, the visual acuity deteriorates. The increase in lacrimal glands is a rare phenomenon.
Characteristic features of the syndrome of Sjogren, which affected the salivary glands: dry mucous in the mouth, red border, lips. Often, patients develop seizures , and, in addition to salivary glands, some of the nearby glands also increase. Initially, the disease manifests itself only with physical exertion or emotional stress. But later the dryness becomes permanent, the lips are covered with crusts that crack, which increases the risk of joining the fungal infection.
Sometimes, due to dryness in the nasopharynx, the crusts begin to form in the nose and auditory tubes, which can lead to otitis and even temporary hearing loss. When the pharynx and vocal cords are strongly overdone, there is hoarse and hoarse. And it also happens that the violation of swallowing leads to atrophic gastritis. The diagnosis is manifested by nausea, worsening of appetite, weight in the epigastric region after eating.
The extragenital manifestations of the symptom complex of Sjogren's syndrome look like this:
- joint pain;
- stiffness of muscles and joints in the morning;
- muscle weakness;
- small bloody rash that occurs against the background of vascular lesions;
- neuritis of the facial or trigeminal nerves;
- hemorrhagic rash on the trunk and extremities;
- dryness of the vagina.
Sjogren's syndrome - differential diagnostics
The definition of the disease is mainly based on the presence of xerophthalmia or xerostomia. The latter is diagnosed by means of sialography, parotid scintigraphy and salivary gland biopsy. For the diagnosis of xerophthalmia, the Schirmer test is performed. One end of a strip of filtered paper is laid under the lower eyelid and left for a while. In healthy people, after about 5 minutes, about 15 mm of the strip will become wet. If the Sjogren's syndrome is confirmed, the diagnosis shows that it is not more than 5 mm wet.
In differential diagnosis it is important to remember that the NLS can develop in parallel with such diagnoses as autoimmune thyroiditis, percinosis anemia, drug disease. Definition of primary dry syndrome is greatly facilitated by the detection of antibodies SS-B. It is most difficult to diagnose Sjogren's disease with rheumatoid arthritis, because joint damage begins long before the appearance of signs of dryness.
Sjogren's syndrome - tests
Diagnosis of the disease involves conducting laboratory tests. When diagnosed with Sjogren's disease, the analyzes show approximately the following results:
- In the general blood test, accelerated ESR, anemia and low white blood cell count are determined.
- The OAM is characterized by the presence of protein.
- The protein is also raised in the biochemical analysis of blood. In addition, the study reveals the maximum titers of rheumatoid factor.
- A special blood test for the presence of antibodies to thyroglobulin in 35% shows an increase in their concentration.
- The results of salivary gland biopsies confirm the symptoms of Sjogren's syndrome.
Sjögren's Syndrome - treatment
This is a serious problem, but it is not fatal. If you pay attention to its signs in time and when you diagnose Sjogren's disease treatment is begun, you can live with it, feeling comfortable with it. The main thing for patients is not to forget about the importance of a healthy lifestyle. This will help to strengthen immunity, will not allow the pathological process to actively develop and significantly reduce the risk of complications.
Is it possible to cure Sjogren's syndrome?
Once the diagnosis is confirmed, the patient receives therapeutic recommendations. Sjogren's syndrome is being treated successfully today, but it is not yet possible to get rid of the disease completely. For this reason, only symptomatic therapy is performed. Criteria for assessing the quality of treatment is the normalization of clinical manifestations of the disease. If all therapeutic purposes help, laboratory indicators and a histological picture improve.
Sjögren's Syndrome - Clinical Recommendations
Therapy of dry syndrome involves alleviating the symptoms and, if necessary, combating the background autoimmune disease. Before the treatment of Sjogren's syndrome, diagnostics is necessarily carried out. After, as a rule, such means are used:
- glucocorticoid Prednisolone (the scheme and dosage is determined individually depending on the severity of the syndrome and the severity of its symptoms);
- angioprotectors - Parmidin, Solcoseryl;
- immunomodulator Splenin;
- anticoagulant Heparin;
- Contrikal or Trasilol - drugs that stop the production of proteolytic enzymes;
- Zioostatics - Chlorbutin, Azathioprine, Cyclophosphamide (basically recommend taking with glucocorticoids).
To get rid of dry mouth, rinse. Dry eye syndrome is treated with instillation of saline, Hemodesis. Dried bronchial tubes and trachea can be treated with Bromhexine . With inflammation of the glands Dimexide, Hydrocortisone or Heparin are struggling. Sometimes dry mouth in the diagnosis of Sjogren's syndrome leads to the development of dental diseases. To prevent them, you need to take care of maximum oral hygiene.
Sjogren's disease - treatment with folk remedies
Dry syndrome is a complex of symptoms and signs. With all of them it is better to fight traditionally. But sometimes with Sjogren's syndrome, folk methods applied in parallel help improve the patient's condition. Some patients, for example, note that eye drops made from dill and potato juice are much more effective than pharmaceutical lacrimal fluids.
Herbal decoction for rinsing
- chamomile flowers - 1 tablespoon;
- sage leaves - 1 tbsp. l .;
- water - 1 glass.
Preparation and use:
- Grasses mix and lightly grind.
- Water boil and pour into a dry mixture.
- The medicine needs to brew for 40 minutes.
- After filtering it is ready for use.
Sjogren's syndrome - prognosis
This disease proceeds without a threat to life. But because of her, the quality of life of patients is deteriorating noticeably. Treatment helps prevent complications and keeps the working capacity of adults - Sjogren's syndrome in children is extremely rare. If therapy does not start, the disease can develop into a severe form, which, when secondary infections, such as bronchopneumonia , sinusitis or recurrent tracheitis, sometimes lead to disability.