Healthy Living

It has been two years since my last column on Sjogren’s Syndrome. Since that time there have been developments that have really highlighted the significance of this diagnosis.

Venus Williams, a two-time U.S. Open women’s tennis champion, is among the approximately 4 million people who may be living with the disorder nationwide, according to the Sjogren’s Syndrome Foundation.

The national attention may have spurred people to seek help locally. At the Backus Arthritis Center, we have seen more patients with symptoms consistent with Sjogren’s, and we have been able to utilize what we are learning about this condition to properly address some of their issues.

So what is Sjogren’s? It is an autoimmune disorder that causes inflammation and affects many different parts of the body. The areas most commonly affected are the tear and the salivary glands. Other parts of the body can also be impacted, including, joints, skin, lungs, and kidney.

Most of the complications of Sjogren’s occur because of decreased tears and saliva. Patients with dry eyes are at an increased risk for infections around the eye and may have damage to the cornea. Dry mouth increases risk of dental infections, decay, gingivitis and oral yeast infection. Patients may have episodes of painful swelling in the salivary glands around the face.

Pain and stiffness in the joints with swelling can occur in patients, and can cause significant stiffness in the morning. Rashes on the arms and legs can happen in patients. This may be related to the inflammation of the blood vessels or inflammation of the skin. Patients also complain of numbness and tingling in their feet related to neuropathy.

What causes Sjogren's? The underlying cause is not known, but it is an autoimmune disorder. Genetic factors and possibly viral infections may predispose people to developing this condition, which can affect people of any age, but symptoms usually appear between the ages of 45 and 55. Women are affected 10 times more often as men. Some of these patients may also have other underlying autoimmune illnesses like rheumatoid or lupus.

How is it diagnosed? Diagnosis is based on combination of symptoms, physical examination and blood tests. Special tests are available to assess the decreased tear production in these patients. Sometimes a lip biopsy is also used for the diagnosis. Blood tests can determine the presence of antibodies and amount of inflammation.

Who manages Sjogren’s? Patients are usually referred to a rheumatologist either by a primary care physician because of fatigue and stiffness or by the eye doctor when they see significant dry eyes. Patients may also be referred by a dentist or an ear, nose and throat specialist for dry mouth or recurrent parotitis.

There are treatment options for patients with Sjogren’s. Each patient is unique and treatment options are tailored to each patient. We always consider pharmacologic and non-pharmacologic options, and work closely with ophthalmologists and dentists to manage the disease.

Sandeep Varma, MD, is a rheumatologist and Medical Director at the Backus Arthritis Center, located at the Backus Outpatient Care Center in Norwich. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Dr. Varma or any of the Healthy Living columnists at healthyliving@wwbh.org