Sjogren's disease is a chronic inflammatory disease of connective tissue that occurs when the immune system is compromised.
As a rule, there is a malfunction, and the body takes its own cells for foreign, producing antibodies.
Often found in middle-aged women, less often in men and children. Distinguishing symptoms of the disease is eye damage, patients can feel a burning sensation, reddening and itchy eyelids, sometimes white corpuscles appear in the corners of the eyes.
Syndrome Sjogren( Gujero syndrome, dry syndrome, autoimmune exocrinopathy) is characterized by nasopharyngeal damage, with the transformation of dry crusts in the nose, which leads to the development of otitis.
Contents of the
About the causes and risk factors
- Progressive symptoms
- Instrumental diagnostic methods
About the causes and risk factors
The main causes of the onset of the disease are unknown. The most frequent is the body's response to various viruses and the occurrence of inflammatory changes in the mucosa, in connection with:
- with supercooling or overheating of the body;
- for the abuse of medicines;
- hypersensitivity of the body;
- when receiving emotional stress, because of the development of autoimmune disease.
- heredity can also be the cause of the manifestation of this disease.
Sjogren's disease affects the respiratory organs in 50% of patients. There is perspiration and dryness in the throat, shortness of breath and cough.
Also affected by blood vessels, the nervous system and allergic reactions to B group vitamins, antibiotics, chemicals and even food products.
Features of clinical picture
Clinical manifestation of the disease is expressed in the dryness of the mucous membrane of the eyes and oral cavity, increased parotid glands and joint damage.
Due to the dryness of the oral cavity, the tongue becomes smooth and pleated. On the lips and tongue appear slowly healing cracks. Almost all patients develop keratoconjunctivitis.
Symptoms of systemic inflammatory disease also show the presence of Sjogren's disease. Lesion of the joints can lead to arthralgia and polyarthritis.
In the photo, the eye is affected by keratoconjunctivitis - a frequent symptom of Sjogren's disease
Progressive symptoms of
The stages of the disease are divided into initial, pronounced and late.
Each stage of the development of Sjogren's syndrome is characterized by its symptoms:
- At the initial stage of , patients often complain of dry mouth and lips, the appearance of stomatitis and dental caries. In this case,
laboratory tests show weak signs of inflammation. - In the second stage of development, symptoms such as photophobia, decreased visual acuity and narrowing of the eye slits appear. The second mandatory sign of the disease manifests itself in the form of an increase in salivary glands and the appearance of dry mouth. If at the beginning of the disease dryness is felt only with physical exertion, then at a pronounced stage the feeling of dryness constantly worries and it becomes necessary to drink solid food. Immunological activity of the organism decreases. Saliva in the mouth is practically absent, becoming viscous and foamy.
- In the later stages of , the absence of saliva in the mouth leads to swallowing disorders, sometimes even speech, the lips crack.
The nature of the course of the pathology of
The flow can be a subacute and chronic form of the syndrome:
- The chronic form of is expressed in the form of glandular manifestations, which are caused by a decrease in the function of secretion of salivary glands and tear glands. Disturbance of the lacrimal glands leads to eye damage, resulting in a burning sensation and a scratch in the eyes. When the function of the salivary glands is broken, the mucous membranes acquire a bright pink color, they are easily traumatized by contact.
- The extragenular form of Sjogren's disease( subacute ) manifests itself as a sign of pain in the joints and muscles. The body temperature rises. In 80% of patients there is an increase and there is soreness of cervical, lymphatic, submandibular nodes. There are bloody rashes on the skin of the legs, eventually spread throughout the body. The thyroid gland inflames, the gland functions increase or decrease.
Diagnosis of
Dry syndrome is determined by changes in laboratory parameters when performing a blood test.
The presence of rheumatoid factors, hypergammaglobulinemia, reduction of leukocytes, the appearance of antibodies to DNA and the acceleration of ESR are the main signs of the disease.
When stimulated with ammonia, the decrease in secretion of tears is determined. Biopsies, MRI and contrast radiography of tear and salivary glands are performed.
To determine the complications of other organs, ECG, gastroscopy and lung X-rays are performed.
Chronic Sjogren's syndrome occurs in 40% of patients. Often they are elderly people, the disease occurs in the form of extra-iron manifestations. Young people often have subacute disease.
Differential diagnosis is performed with systemic lupus erythematosus, rheumatoid arthritis and autoimmune diseases.
Instrumental diagnostic methods
Instrumental methods for determining the disease are used. To do this, the filter paper is laid behind the lower eyelid and the length of the wetted paper is measured with a tear. If the result is less than 5 mm, the presence of the disease is guaranteed.
The second method is sialografiya-introduced a contrast agent in the parotid duct with radiography, the expansion of the duct indicates the presence of the disease.
Therapeutic approach
Treatment of Sjogren's disease should be comprehensive, aimed at restoring immune disorders and individual organs. The doctor-rheumatologist, the ophthalmologist and the stomatologist should be engaged in treatment. 
If severe symptoms of the disease are not present, treatment with prednisolone in small doses is prescribed. The expressed and late stage of the disease requires therapy with Prednisolone and Chlorbutin, followed by treatment for several years.
The most effective treatment for severe systemic manifestations of the disease is pulse therapy with prednisolone and cyclophosphamide in large doses followed by a transition to moderate.
With pronounced immunological disorders, a combination of plasmapheresis and pulse therapy is performed, which is an effective method in the treatment of subacute Sjogren's syndrome.
To treat mucosal dryness, symptomatic treatment is performed:
- For the purpose of eye protection, uses drops containing artificial tear, soft contact lenses, to prevent virus diseases, wash the eyes with solutions of antiseptics.
- To normalize the salivation in the mouth prescribed drugs containing calcium, antibiotics and used novocaine blockades.
- To soften lips and mouth use sea buckthorn oil and rose hips. Also, products that increase salivation( orange, lemon, grapefruit, horseradish, mustard) are prescribed.
- Secretory gastric insufficiency is treated with the use of hydrochloric acid and natural gastric juice. With
, a solution of Dimexide is used for the development of chronic mumps. - For the treatment of dryness of the nasopharynx , applications of sodium solution using turundochek are used.
- Dryness of the bronchi and trachea is treated with a prolonged intake of Bromhexine.
Treatment of patients with Sjogren's syndrome with infections caused by cryoglobulinemia is performed in an extracorporeal fashion in conjunction with pulse therapy.
If these methods are ineffective, blood purification with a special device from autoantibodies is performed.
Complications and consequences of
In case of untimely treatment there may be complications. As a rule, these are viral diseases and infections: sinusitis, pneumonia, bronchitis and tracheitis. In 1/3 of patients, external genital organs are affected. There is dryness, burning and redness of the vagina.
Due to the decrease in sweating, the skin becomes dry. Often there is a violation of the digestive system, chronic gastritis develops, in this regard, the appetite decreases and nausea appears. Most infected have liver and biliary tract disease.
For the prevention of
To prevent a violation, all the doctor's instructions must be followed to prevent exacerbations. Also it is necessary to observe some simple rules:
- to limit the load on the organs of vision;
- if the syndrome is caused by another disease, you need to treat the cause of the occurrence.
- to avoid stressful situations;
The course of Sjogren's disease does not threaten human life. Slow progression of the syndrome is possible with the timely treatment of the disease.
In this case, the patients' work capacity is restored.
Later treatment of the disease, usually ends up getting disability patients due to the development of severe manifestations and complications of other systems.