Tuesday, August 23, 2011

sjogren's syndrome

What is Sjogren's Syndrome? Sjogren's syndrome is a chronic, slowly progressive, inflammatory autoimmune disorder characterized by the infiltration of specialized cells of the immune system called lymphocytes (T-cells in the majority of cases), monocytes, and plasma cells into the parotid (salivary) glands and lacrimal (tear) glands. These glands are part of a group of exocrine glands whose secretions pass into a system of ducts that lead ultimately to the exterior of the body. This chronic lymphocytic infiltration interferes with the normal function of these glands and eventually results in a significant reduction or cessation in the production and secretion of saliva and tears. The condition is named after Henry Sjogren, a Swedish ophthalmologist, who first described the primary clinical features of this disorder in 1933. In approximately 40% of patients, Sjogren's syndrome progresses beyond the exocrine glands and systemic (extraglandular) features develop. Two distinct forms of Sjogren's syndrome have been recognized: Primary Sjogren's syndrome - defined as dry eye and dry mouth that occurs by itself and is not associated with another autoimmune disorder. Primary Sjogren's syndrome occurs in approximately 50% of cases according to the Sjogren's Foundation of America. Secondary Sjogren's syndrome - characterized by dry eye and dry mouth that occurs in the presence of a major underlying autoimmune connective tissue disease such as rheumatoid arthritis, systemic lupus erythematosus, or scleroderma. It has been estimated that up to 4 million Americans are afflicted with Sjogren's syndrome and that 1-2% of the population in the United States has been diagnosed with Sjogren's syndrome. However, because the disorder may be difficult to diagnose, the incidence of the disease may be considerably higher. Sjogren's syndrome is a condition that affects primarily women with a female to male ratio of about 24:1, meaning that about 95% of people who suffer from Sjogren's syndrome are women. Symptoms of the disorder most often begin between the ages of 40-60, predominantly in peri/post menopausal women, but are also seen in young women in their 20s and 30s. The average age of onset is 52 years old. The overall prevalence of Sjogren's syndrome in the general population has been estimated to range from 0.5% to 3.0%. Knowledge is Critical when Dealing with a Life-Altering Condition such as Sjogren's Syndrome Fundamentally important information about Sjogren's syndrome, including: The theories regarding the underlying causes of Sjogren's syndrome, which include: o Chronic inflammation o Cellular apoptosis (self-death of a cell) o Autonomic nervous system dysfunction o Neurotransmitter abnormality o Genetic predisposition The classic signs and symptoms of Sjogren's syndrome affecting the oral cavity and the eyes. The signs and symptoms of Sjogren's syndrome that affects other areas of the body, known as systemic or extraglandular features of Sjogren's, which may include: o Sinus symptoms o Cutaneous (skin) symptoms o Vasculitis - inflammation of the blood vessels o Pulmonary (lung) symptoms o Kidney/bladder symptoms o Gastrointestinal symptoms o Neurological symptoms o Gynecological symptoms How Sjogren's syndrome is diagnosed based on factors such as signs/symptoms, patient history, physical examination, and examination of the oral cavity and eyes. Special laboratory tests that are used to confirm the diagnosis of Sjogren's syndrome that are designed to measure abnormalities in the production of saliva and tears. Understanding the Standard Treatments...and the Treatment Options Currently there is no known cure for Sjogren's syndrome. The major goals of treatment are to control the symptoms and prevent or limit the involvement of other organs of the body. Understanding the standard treatments - and the treatment options - is crucial for successfully achieving the goals of treatment and, thereby, enabling the patient to maintain a reasonably good overall quality of life. The treatment options that are available to better manage the symptoms associated with dry mouth, including: o Saliva substitutes o Saliva stimulants o Interferon-alpha o Good oral hygiene practices o Lifestyle modifications The treatment options that are available to better manage dry eye symptoms, including: o Artificial tears o Methylcellulose inserts o Eye ointments o Muscarinic agonist drugs o Immunomodulatory drugs o Autologous serum drops o Lifestyle modifications o Punctual occlusion surgery


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