Treatment of Sjögren’s Syndrome

Dry eyes, a feeling of dryness in the mouth, and constant thirst may be manifestations not only of insufficient fluid intake but also of an autoimmune disease. If such symptoms persist for a long time and are combined with fatigue, joint pain, or other complaints, it is worth consulting a doctor.

Sjogren's syndrome usually develops gradually, and its manifestations are easily confused with overwork, age-related changes, or other diseases. Because of this, patients often seek medical care only when the symptoms begin to significantly affect quality of life.

At the Oxford Medical medical center, you can undergo the necessary diagnostics, receive a consultation with a rheumatologist and an individual treatment plan. Early detection of the disease helps control its course, reduce the severity of symptoms, and lower the risk of developing complications.

Sjogren's syndrome — is a chronic autoimmune disease of connective tissue, in which the immune system mistakenly affects mainly the exocrine glands. Its characteristic sign is dry syndrome, which manifests as dryness of the eyes, oral cavity, and other mucous membranes. The disease can occur both independently and be combined with other autoimmune pathologies.

According to National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), Sjogren's syndrome is most often diagnosed in middle-aged women, although the disease can also develop in men or younger people. It belongs to systemic autoimmune diseases, therefore, in addition to the lacrimal and salivary glands, it can affect the joints, skin, lungs, kidneys, nervous system, and other organs.

The exact cause of the development of Sjogren's syndrome has not been definitively established. It is believed that the disease occurs as a result of a combination of genetic predisposition, impaired immune regulation, and the influence of external factors that can trigger an autoimmune process.

The factors that may be associated with the development of Sjogren's disease include:

• hereditary predisposition to autoimmune diseases;

• impaired functioning of the immune system;

• previous viral infections;

• hormonal factors, since the disease occurs significantly more often in women;

• the presence of other autoimmune diseases.

According to MSD Manual, Sjogren's syndrome can be primary, when it develops as an independent disease, or secondary — when it occurs against the background of other autoimmune pathologies, in particular rheumatoid arthritis, scleroderma, or systemic lupus erythematosus.

One of the most characteristic manifestations of the disease is dry eye syndrome, which is accompanied by burning, redness, a feeling of sand in the eyes, photophobia, and rapid fatigue during visual strain.

In women, Sjogren's syndrome may also manifest as dryness of the vaginal mucous membrane, which sometimes causes discomfort, pain during sexual life, or increases the risk of developing vaginitis and other inflammatory processes.

Doctors of «Oxford Medical» recommend not ignoring prolonged dryness of the eyes or mouth, especially if it is combined with joint pain, fatigue, or other unclear symptoms. Timely consultation with a rheumatologist allows the diagnosis to be established faster and treatment to be started.

Diagnosis of Sjogren's syndrome begins with a consultation with a rheumatologist. The doctor performs an examination and clarifies complaints, and also finds out whether the patient has other autoimmune diseases.

To clarify the diagnosis, the following may be prescribed:

• general blood and urine tests;

• biochemical blood test;

• immunological studies, in particular determination of autoantibodies (SSA/Ro, SSB/La, ANA, rheumatoid factor);

• tests to assess tear production (Schirmer test);

• ultrasound examination of the salivary glands.

If the patient is bothered by burning, redness, a feeling of sand in the eyes, or worsening of vision, it is also recommended to consult an ophthalmologist. If there are rashes, dry skin, or other skin manifestations, a consultation with a dermatologist is necessary.

Sjogren's syndrome has symptoms similar to the manifestations of other diseases, therefore the final diagnosis is established only after a comprehensive assessment of complaints, the results of laboratory analyses, and instrumental examinations.

How to treat Sjogren's disease

According to EULAR recommendations, the treatment tactics are selected individually. They depend on the predominant manifestations of the disease and may include both local remedies for eliminating dryness and systemic therapy in case of damage to internal organs. The main goal of treatment is to reduce the manifestations of the disease, prevent complications, and control the activity of autoimmune inflammation.

Treatment may include:

• moisturizing drops and gels for the eyes — to reduce dryness, burning, and irritation;

• preparations for stimulating salivation — in case of pronounced dryness of the oral cavity;

• anti-inflammatory, immunomodulating, or immunosuppressive preparations — to control autoimmune inflammation in the presence of systemic manifestations.

Doctors of «Oxford Medical» recommend not engaging in self-treatment and not using preparations without consulting a specialist. Properly selected therapy helps control the course of the disease and reduce the severity of symptoms.

Without timely treatment, Sjogren's syndrome can lead not only to increased dryness of the mucous membranes, but also to the development of more serious complications. The risk of their occurrence depends on the activity of the autoimmune process, the duration of the disease, and the timeliness of the therapy started.

Possible complications of Sjogren's syndrome:

• damage to the cornea and worsening of vision due to prolonged dryness of the eyes;

• development of caries, inflammation of the gums, and fungal infections of the oral cavity as a result of insufficient saliva production;

• damage to the joints, lungs, kidneys, nervous system, and other internal organs;

• increased risk of developing lymphoma with a prolonged course of the disease.

Timely diagnosis, regular observation by a rheumatologist, and following the doctor's recommendations help control the course of the disease, reduce the risk of developing complications, and maintain quality of life.

It is impossible to completely prevent the development of Sjogren's syndrome, since it is an autoimmune disease. At the same time, timely detection of the disease, regular observation by a doctor, and adherence to treatment recommendations help control its course and reduce the risk of developing complications.

To prevent progression of the disease, it is recommended to:

• regularly visit a rheumatologist and undergo follow-up examinations;

• not stop the prescribed treatment without agreement with the doctor;

• use products for moisturizing the eyes and the mucous membrane of the mouth according to the doctor's recommendation;

• maintain a sufficient drinking regimen, give up smoking, and avoid factors that increase dryness of the mucous membranes.

Doctors of «Oxford Medical» recommend consulting a doctor when new symptoms appear or already existing manifestations of the disease intensify. Regular monitoring allows treatment to be adjusted in a timely manner and the progression of the disease to be prevented.

The cost of treatment of Sjogren's syndrome depends on the form of the disease, the severity of symptoms, and the prescribed therapy. In some cases, a consultation with a rheumatologist and laboratory diagnostics are sufficient, in others additional examinations and long-term observation may be needed.

You can preliminarily familiarize yourself with the prices for doctors' consultations here. During the appointment, the doctor will assess the results of examinations, determine the further treatment tactics, and orient you regarding the cost of the necessary medical services.

To make an appointment at a time convenient for you, contact the contact center of «Oxford Medical» or use the online appointment form on the website.

The information is for informational purposes and does not replace a doctor's consultation.

Sources:

• National Institute of Arthritis and Musculoskeletal and Skin Diseases

• MSD Manual

• EULAR — European Alliance of Associations for Rheumatology