Our Services

Sjögren's Syndrome

Rheumatology

Sjögren's Syndrome is a chronic autoimmune disease that causes inflammation and dysfunction of the glands, primarily affecting the salivary and tear glands, leading to dry mouth and dry eyes. Additionally, this disease can also impact the secretory glands of the upper respiratory tract, throat, vagina, and skin, resulting in dryness in these areas.

Symptoms

Dry mouth: Patients experience a dry mouth, leading to frequent mouth ulcers, dental caries, gum inflammation, and difficulty swallowing.
Dry eyes: Symptoms include itchy, burning, red, and sensitive eyes, as well as potential corneal damage.
Other dryness symptoms: Dry skin, vaginal dryness, and dryness in the upper respiratory tract.
Systemic symptoms: Joint pain, fatigue, rash, muscle weakness, and swollen lymph nodes.
Severe complications: A few patients may develop lymphoma, lung disease, or kidney disease.

Causes and Factors

Causes
The exact cause of Sjögren's Syndrome is unknown. It is likely related to a combination of genetic predisposition, viral infections such as hepatitis C, cytomegalovirus, Epstein-Barr virus (EBV), and other autoimmune diseases.

Risk Factors

Gender: Women are at a higher risk of developing Sjögren's Syndrome, with a female-to-male ratio of about 10:1.
Age: The condition commonly occurs between the ages of 40 and 50.
Other autoimmune diseases: Conditions such as rheumatoid arthritis and lupus increase the risk.
Family history: Having direct relatives with Sjögren's Syndrome or other autoimmune diseases increases the risk.

Diagnosis

Clinical Examination	Clinical examination is the first step in diagnosing Sjögren's syndrome. Doctors can gain an initial understanding of the patient's symptoms and overall health through a detailed medical history and physical examination. Key areas of focus include whether the patient experiences dry mouth, dry eyes, and dry skin, as well as any related autoimmune conditions such as rheumatoid arthritis or lupus.
Blood Tests	Sjögren's syndrome is an autoimmune disease, and blood tests are used to detect specific autoantibodies and markers of inflammation. These indicators help confirm abnormal immune system activity. Antinuclear Antibodies (ANA): This nonspecific autoantibody is commonly positive in patients with Sjögren's syndrome. Anti-Ro/SSA and Anti-La/SSB Antibodies: These are specific antibodies for Sjögren's syndrome, and a positive result strongly suggests the presence of the disease. Inflammation Markers: C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are indicators that reflect the presence of systemic inflammation.
Schirmer Test	The Schirmer test is a simple procedure used to assess the functioning of the lacrimal glands. It is typically used to measure tear production, as patients with Sjögren's syndrome often experience reduced tear secretion.
Salivary Gland Imaging	Salivary gland imaging uses techniques such as ultrasound or MRI to examine the structure and function of the salivary glands, looking for signs of gland enlargement, structural abnormalities, or reduced saliva production. Ultrasound Examination: A non-invasive technique to detect salivary gland enlargement or structural abnormalities; it is easy to perform and radiation-free. MRI Examination: Provides more detailed images of the salivary gland structure, showing inflammation and fibrosis within the glands.
Tissue Biopsy	A biopsy involves taking a sample from the affected salivary gland or skin, often from the salivary glands inside the lower lip, to check for lymphocyte infiltration, a typical pathological feature of Sjögren's syndrome. Microscopic examination of the inflammation cells' quantity and distribution helps confirm the characteristic inflammatory response.

Treatments

Eye Treatment	For patients with Sjögren's syndrome, insufficient tear production can lead to dry eyes, discomfort, and even corneal damage. Eye treatment aims to alleviate these symptoms by increasing or mimicking tear production. Artificial Tears: Used to supplement natural tears, providing continuous lubrication to reduce dryness and discomfort. Suitable for frequent use, especially in dry environments or during prolonged use of electronic devices. Lubricating Eye Drops: Similar to artificial tears but with a longer-lasting effect, typically used at night to help repair corneal damage during sleep. Punctal Plugs Surgery: Involves inserting small plugs to block tear drainage, thereby increasing tear retention time in the eyes and keeping them moisturized.
Oral Treatment	Saliva-Stimulating Medications: Medications such as Pilocarpine and Cevimeline activate receptors in the salivary glands to increase saliva production, effectively relieving dry mouth symptoms. Drinking Water: A simple method to keep the mouth moist, which is beneficial during meals or conversations to alleviate dryness. Chewing Sugar-Free Gum: Mechanically stimulates the salivary glands, increasing saliva production, improving oral moisture, and reducing the risk of cavities.
Skin and Vaginal Treatment	Sjögren's syndrome affects not only the eyes and mouth but also leads to dryness of the skin and vagina. These treatments aim to reduce dryness symptoms by externally supplementing moisture, preventing further damage and infection. Moisturizers: Using moisturizers containing hydrating ingredients helps maintain the skin's moisture barrier, preventing cracking and itching. Vaginal Lubricants: Specifically designed for vaginal dryness, these lubricants reduce friction, improve the quality of sexual intercourse, and lower the risk of infection.
Anti-Inflammatory Medications	Sjögren's syndrome can trigger systemic inflammation, especially arthritis. Anti-inflammatory medications aim to reduce these inflammatory responses, alleviating pain and stiffness. Non-steroidal anti-inflammatory Drugs (NSAIDs): Such as ibuprofen, relieve mild to moderate joint inflammation and pain. Hydroxychloroquine: Originally an antimalarial drug, it is also commonly used to treat autoimmune diseases, effectively reducing joint symptoms and slowing disease progression.