Non-Neoplastic Salivary Gland Diseases
John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford in Head & Neck Surgery Plastic Surgery, 2018
Sjogren’s syndrome occurs in 0.2%–3% of populations, seems to have no geographic or ethnic associations but is possibly nine times more common in women than men. Disease is usually detected in the 4th–6th decade of the patient’s life, although Sjögren’s syndrome can arise in younger adults and occasionally in children under 10 years of age. Sjögren’s syndrome probably remains underdiagnosed, possibly reflecting the generally mild nature of the clinical signs in some patients. In addition, there is an increasingly wide range of other disorders that may give rise to clinical features similar to those of Sjögren’s syndrome—notably infection with HIV, HCV and chronic graft-versus-host disease. Many asymptomatic people have circulating ANAs relevant to Sjögren’s syndrome, but these are generally present in low titre and are not indicative of a future risk of Sjögren’s syndrome.
Sjögren syndrome and mixed connective tissue disease
Biju Vasudevan, Rajesh Verma in Dermatological Emergencies, 2019
Currently, there is no one treatment that can take care of all of the manifestations of Sjögren syndrome or that can modify its natural course. Treatment is directed toward the affected system. Treatment strategies for different cutaneous manifestations are summarized in Table 43.1 [4,5]. Drawing from the experience from other rheumatic diseases, hydroxychloroquine is often used for fatigue, muscle, and joint pains. For more severe internal organ involvement, systemic corticosteroids and steroid-sparing agents such as methotrexate, azathioprine, and cyclophosphamide are used [26]. TNF-α blockers such as infliximab and etanercept have also been tried for the treatment of sicca symptoms with variable results [27,28].
Complementary and Alternative Medicine Use in Rheumatic Disease
Jason Liebowitz, Philip Seo, David Hellmann, Michael Zeide in Clinical Innovation in Rheumatology, 2023
For people living with lupus, mindfulness has not been as well studied. However, pilot studies suggest improvements in mental health, but not for lupus disease activity.53, 54 A single pilot study was also conducted for people living with Sjögren’s syndrome.55 There were improvements in mental health and perceived stress; Sjögren’s disease activity was not evaluated. Mindfulness hasn’t been explicitly studied in other rheumatic diseases but recognized by the Myositis Association and Vasculitis Foundation as a potentially beneficial form of stress reduction.
Effect of Rapamycin Microspheres in Sjögren Syndrome Dry Eye: Preparation and Outcomes
Published in Ocular Immunology and Inflammation, 2019
Shasha Wang, Meng Wang, Yan Liu, Daode Hu, Lei Gu, Xinfeng Fei, Jianhong Zhang
Sjögren’s syndrome is a chronic systemic autoimmune disease that mainly affects the salivary and lacrimal glands, causing dry eye, dry mouth, and other multi-system dysfunctions.1 In patients with Sjögren’s syndrome, inflammatory injury of the ocular surface can cause loss of vision and other ocular symptoms.1 At present, Sjögren’s syndrome is most often treated using local application of glucocorticoids and immunosuppressant drugs, including the combined application of glucocorticoids, immunosuppressants, and artificial tears directly to the eye. Nevertheless, the long-term use of glucocorticoids can be harmful to the eye, causing adverse side effects, including glaucoma, cataract, atrial degeneration, and other ocular complications including rebound phenomenon and drug resistance.2 Thus, alternative therapeutic options are being sought to improve the quality of life of patients experiencing the ocular signs of Sjögren’s syndrome.
Longitudinal analysis of tear cathepsin S activity levels in male non-obese diabetic mice suggests its potential as an early stage biomarker of Sjögren’s Syndrome
Published in Biomarkers, 2019
Srikanth R. Janga, Mihir Shah, Yaping Ju, Zhen Meng, Maria C. Edman, Sarah F. Hamm-Alvarez
The autoimmune disease, Sjögren’s Syndrome (SS), is characterized by lymphocytic infiltration and altered secretory function of lacrimal gland (LG) and salivary gland (SG), causing autoimmune-mediated dry eye and dry mouth, respectively (Fox and Kang 1992, Ramos-Casals 2012). SS is a chronic systemic disease, with patients experiencing additional symptoms of weight loss, fatigue, and inflammation of the heart, kidney, brain, lungs, liver, nervous system, and/or gastrointestinal tract which can worsen over time (Tzioufas and Voulgarelis 2007, Voulgarelis et al.2008). SS patients are also 44 times more likely to develop non-Hodgkin’s B-cell lymphoma, which in turn may lead to high-grade malignant tumors (Kassan et al.1978, Ambrosetti et al.2004). SS can be classified into primary (pSS) and secondary (sSS) disease, based on the development of symptoms in the absence or presence, respectively, of other autoimmune diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) (Peri et al.2012, Patel and Shahane 2014).
Ocular Pathophysiology of Sjögren’s Syndrome
Published in Ocular Immunology and Inflammation, 2021
Zujaja Tauqeer, Vatinee Y. Bunya, Ilaria Macchi, Mina Massaro-Giordano
This constellation of findings and its systemic associations have been described in the scientific literature since the late nineteenth and early twentieth centuries, when case reports emerged from Europe describing patients with dry eyes suffering from other dysfunctions of the endocrine system, including rheumatism or gout, as well as lymphocytic aberrations.1 In a series of cases published in the 1930s, the Swedish physician Henrik Sjögren described the cases of 19 female patients of menopausal age suffering from arthritic symptoms who presented with complaints of scratchy eyes with foreign body sensation, burning, and photophobia, and whose conjunctiva stained with rose Bengal, a condition which he termed keratoconjunctivitis sicca and which has since come to bear his own name.2,3 He also presented histological evidence of inflammatory infiltration of the conjunctiva, lacrimal glands, and salivary glands in these patients. Nearly 100 years later there are no one universally accepted criteria for the diagnosis of Sjögren’s syndrome, which can have dry eyes or dry mouth, as classically expected, or less well-known extra-glandular manifestations.4
Related Knowledge Centers
- Fatigue
- Lacrimal Gland
- Thyroid Disease
- Xerostomia
- Autoimmune Disease
- Chronic Condition
- Salivary Gland
- Dry Eye Syndrome
- Xeroderma
- Lymphoma