Sjogren's Syndrome is one of more than 100 known autoimmune diseases. It affects between two and three per cent of the general population. Women are nine times more likely to be affected than men. The main targets of this miserable condition are the secretary glands. The most commonly affected are the salivary or parotid glands and the tear ducts. With a mean time to diagnosis of nine years, it is natural to wonder if there are any early warning signs. The answer is very surprising.
The human immune system evolved to protect us from invasion by foreign organisms such as bacteria, viruses and other microscopic parasites. Sometimes it mistakes host tissue for a pathogen, ramping into overdrive to attack the body’s own cells. When the body turns against itself, this is called autoimmunity (AI). Sjögren’s Syndrome (pronounced SHOW-grins) (SS) is one of more than a hundred known AI conditions. Others include Rheumatoid Arthritis, Fibromyalgia, Systemic Lupus Erythematosis. All present with neuropsychiatric symptoms, usually long before they are correctly diagnosed.
The incidence of Sjogren's Syndrome (SS) is approximately 2% to 3% of the general population, with women nine times more likely than men to be affected. Here, the secretory glands are the target of immune system attack. This is particularly true for the tear ducts and salivary glands, although other organs including the pancreas may become involved. This is a systemic disease, affecting every aspect of life. Nearly all individuals who have SS report overwhelming fatigue and muscle pain and weakness. The average time to diagnosis is nine years.
Physical Symptoms of Sjogren's Syndrome
The most common and main symptoms of Sjogren's Syndrome are dry eyes and a dry mouth, of course that could be anything actually. A person’s eyes might itch, burn or feel gritty as if sand is in the eyes. The mouth might feel as if it is full of cotton, making speaking or swallowing difficult.
Other symptoms of Sjogren's Syndrome include:
- Swollen salivary glands, particularly the glands located behind your jaw and in front of your ears.
- Joint pain with stiffness and swelling.
- Skin rashes or dry skin.
- Persistent dry cough.
- Vaginal dryness.
- Prolonged fatigue.
Psychiatric symptoms often precede a diagnosis of AI
Evidence associating autoimmune pathology with neuropsychiatric illness among this population comes from autoantibody expression, infarcts (stroke) and seizure activity. Central Nervous System (CNS) manifestations of SS present most frequently as atypical mood disorder, although psychosis, dementia, dissociation, personality disorders and panic have also been described.
Systemic Lupus Erythematosis (SLE) is a multisystem autoimmune disease affecting half a million Americans. Nearly all individuals with SLE experience joint and muscle pain, often as the first symptom. Roughly half of those who develop organ-threatening conditions of the heart, lungs, liver, kidneys or central nervous system do not survive for more than 20 years after they have been diagnosed. This condition mainly afflicts women of childbearing age. Neuropsychiatric illness, including psychosis, schizophrenia and erotomania are common afflictions in this population. Disorders of cognition and mood and hypergraphia have also been reported.
A simple solution
In many autoimmune conditions, psychiatric symptoms frequently appear long before the development of defining physical symptoms and signs. There are actually more reports of central SS in the rheumatology and neurology literature than there are in psychiatric journals. This suggests that when patients present with neuropsychiatric symptoms that do not respond to standard therapies, general practitioners and psychiatrists should consider looking for an underlying autoimmune disorder.
Determining the presence of an inflammatory condition is neither difficult nor expensive. If simple blood tests for erythrocyte sedimentation rate (ESR) and C-Reactive Protein (CRP) were incorporated as part of a routine work-up for patients presenting with these complaints, it could point clinicians in the right direction for corrective therapy. Years of suffering could be circumvented.
Sjogren's Syndrome Diagnosis
There are several ways to diagnose Sjogren's Syndrome, or at least limit the possible causes for the symptoms. Since these symptoms mimic so many other illnesses, it can take time for a proper diagnosis.
- Blood tests will check for the presence of antibodies common in Sjogren's Syndrome.
- Eye tests can measure the dryness of your eyes with a test called a Schirmer tear test.
- Imaging tests can check the function of your salivary glands.
- A lip biopsy can detect the presence of clusters of inflammatory cells, which can indicate Sjogren's syndrome.
There are several drugs your doctor can prescribe that can help with Sjogren's Syndrome symptoms. Plus there are home remedies that can help with the symptoms.
Some of the home remedies to relieve a dry mouth include no smoking, drink plenty of fluids, sugar free gum or sucking on citrus candies will help. Also using a saline nasal spray will help keep your nose moist and clear the nasal passages.
To relive dry eyes, you can try a product called artificial tears, and increase the humidity of your home. To increase the humidity, you can buy a humidifier and also boil a pot of water occasionally will increase the humidity. Ayr (pronounced Air) is a good saline nasal spray product made by B. F. Ascher Inc, which you can find at most grocery and drug stores.