Sjögren's Syndrome
is an autoimmune disease in which the body's immune system
mistakenly attacks its own moisture producing glands. Sjögren's is
one of the most prevalent autoimmune disorders, striking as many as
4,000,000 Americans. Nine out of ten patients are women. The average
age of onset is late 40s although Sjögren's occurs in all age groups
in both
women and men.
About 50% of the time Sjögren's syndrome occurs alone, and 50% of
the time it occurs in the presence of another connective tissue
disease. The four most common diagnoses that co-exist with Sjögren's
syndrome are Rheumatoid Arthritis, Systemic Lupus, Systemic
Sclerosis (scleroderma) and Polymyositis/Dermatomyositis. Sometimes
researchers refer to the first type as "Primary Sjögren's" and the
second as "Secondary Sjögren's." All instances of Sjögren's syndrome
are systemic, affecting the entire body.
The hallmark symptoms are dry eyes and dry mouth. Sjögren's may also
cause dryness of other organs, affecting the kidneys, GI tract,
blood vessels, lung, liver, pancreas, and the central nervous
system. Many patients experience debilitating fatigue and joint
pain. Symptoms can plateau, worsen, or go into remission. While some
people experience mild symptoms, others suffer debilitating symptoms
that greatly impair their quality of life.
Early diagnosis and treatment are important for preventing
complications. The symptoms of Sjögren's syndrome may overlap
with or "mimic" those of other diseases including lupus,
rheumatoid arthritis, fibromyalgia, chronic fatigue
syndrome, and multiple sclerosis. Furthermore, dryness can
occur for other reasons, such as a
side effect of medication like
anti-depressants or
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high blood pressure medication.
Additionally, because all symptoms are not always present at the
same time and because Sjögren's can involve several body systems,
physicians and
dentists sometimes treat each symptom individually and do not
recognize that a systemic disease is present. The average time from
onset of symptoms to diagnosis is over six years. Rheumatologists
have primary responsibility for diagnosing and managing Sjögren's
syndrome.
Once Sjögren's syndrome is suspected, a physician will request a
series of blood tests, including:
ANA (Anti-Nuclear Antibody)
ANAs are a group of antibodies that react against normal components
of a cell nucleus. About 70% of Sjögren's patients have a positive
ANA test result.
SSA and SSB
The antibodies SSA (or RO) and SSB (or LA) are often found in
Sjögren's syndrome; 70% of patients are positive for SSA and 40% are
positive for SSB.
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