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Sjgren's SyndromeSjgren's syndrome is an autoimmune disorder in which immune cells attack and destroy the glands that produce tears and saliva. It is named after the Swedish ophthalmologist, Dr. Henrik Sjgren (1899-1986), who first described it. Sjgren's syndrome is also associated with rheumatic disorders such as rheumatoid arthritis, and it is rheumatoid factor positive in 90% of the cases. The hallmark symptoms of the disorder are dry mouth and dry eyes. In addition, Sjgren's syndrome may cause skin, nose, and vaginal dryness, and may affect other organs of the body including the kidneys, blood vessels, lungs, liver, pancreas, and brain. Diagnosis Diagnosing Sjgrens syndrome is complicated by the range of symptoms a patient may manifest, and the similarity between symptoms from Sjgren's syndrome and those caused by other conditions. Nevertheless, several tests can confirm a diagnosis of Sjgren's syndrome. Blood tests can be done to determine if a patient has high levels of antibodies that are indicative of the condition, such as anti-nuclear antibody (ANA) and rheumatoid factor, which are associated with autoimmune diseases. The Schirmer test measures the production of tears: a strip of filter paper is held inside the lower eyelid for five minutes, and its wetness is then measured with a ruler. A slit-lamp examination is done to look for dryness on the surface of the eye. Salivary gland function can be tested by collecting saliva and determining the amount produced. A lip biopsy can reveal lymphocytes clustered around salivary glands, and damage to these glands due to inflammation. Treatment There is no known cure for Sjgren's syndrome nor is there a specific treatment to restore gland secretion. Treatment is generally symptomatic and supportive. Moisture replacement therapies such as artifical tears may ease the symptoms of dryness (some patients with more severe problems use goggles to increase local humidity). Nonsteroidal anti-inflammatory drugs may be used to treat musculoskeletal symptoms. For individuals with severe complications, corticosteroids or immunosuppressive drugs may be prescribed. Also, disease-modifying antirheumatic drugs (DMARDs) such as methotrexate may be helpful. Prognosis Sjgren's can damage vital organs of the body with symptoms that may plateau, worsen, or go into remission. Some people may experience only the mild symptoms of dry eyes and mouth, while others go through cycles of good health followed by severe disease. Many patients are able to treat problems symptomatically. Others are forced to cope with blurred vision, constant eye discomfort, recurrent mouth infections, swollen parotid glands, hoarseness, and difficulty in swallowing and eating. Debilitating fatigue and joint pain can seriously impair quality of life. Research The goals of research on disorders such as Sjogren's syndrome focus on increasing knowledge and under-standing of the disorder, improving diagnostic techniques, and finding ways to treat, prevent, and cure the disorder. Reference - Sjgren H. Zur Kenntnis der keratoconjunctivitis sicca. Doctoral thesis, 1933.
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