Courtesy of THIS Quarterly magazine
 
 
Sjogren's Syndrome
   
     
 
SJÖGREN’S SYNDROME IS AN AUTOIMMUNE DISEASE WHERE THE PATIENT’S TEAR and salivary glands suddenly stop working. Like all autoimmune diseases, it is the result of the body’s immune system failing to recognise the body’s tissues as its own - in this case, the body’s tear and salivary glands - and turning on them. Once so attacked, these exocrine glands stop working properly, causing some of the disease’s hallmark symptoms such as dry eyes and mouth, persistent pain in the joints, rashes, cough and breathlessness.

Sjögren’s syndrome can either occur on its own (primary Sjögren’s syndrome) or coexist with another autoimmune disease (secondary Sjögren’s syndrome) such as rheumatoid arthritis, scleroderma or lupus.

For reasons unknown to modern medical science, Sjögren’s syndrome is more common in women. However, this tendency is not unique to Sjögren’s syndrome; autoimmune diseases in general tend to affect more female than males.

Unfortunately, there is no known way to cure the disease or even prevent it from occurring. The number of factors associated with the progression of the disease makes it difficult to understand both the causal mechanism of the disease as well as the possible risk factors. Current medical theory suggests that a patient must first be genetically predisposed to the disease and, secondly, be hit with a specific type of virus. The presence of the virus in the patient’s body starts overproduction of myeloid dendritic cells, which in turn causes the body’s immune system to start attacking itself.
  Although there is no cure, patients are often able to alleviate the symptoms of Sjögren’s syndrome through the use of artificial tears and medicine from an ophthalmologist (eye doctor). The feeling of a persistently dry mouth, in turn, can be lessened through the use of certain mouthwashes, gels and toothpaste.

If the dry eyes become too detrimental to the patient’s quality of life, he or she may also consider the use of punctal plugs. Essentially intentional blockages of the eyes’ lower puncta, where tears would normally be drained away from, these plugs will cause tears - both artificial as well as natural - to stay on the eye longer, lessening the discomfort associated with dry eyes.

It is also extremely important that the patient undergo appropriate preventive dental treatment as a dry mouth is the ideal environment for cavity-causing bacteria to grow. Existing cavities must also be treated as soon as possible due to the risk of the cavity spreading into the pulp of the tooth, leading to a loss of tooth vitality and eventually necessitating extraction or root canal therapy.

In the event that the symptoms prove to be extremely serious, a rheumatologist may eventually prescribe the patient with medication to calm the immune system. This is usually done as a last resort as these drugs - known as immunosuppressants - will naturally weaken the patient’s immune system, making it more likely that he/she may fall prey to other diseases.
 
 
 
A/PROF LEONG KENG HONG

MBBS (Singapore) 1983
Master of Medicine (Singapore) 1989
Doctor of Medicine 2005
Member of the Royal College of Physicians (UK) 1989
Fellow of the Academy of Medicine, (Singapore) 1992
Fellow of the Royal College of Physicians (Edinburgh) 1997

Leong Keng Hong Arthritis and Medical Clinic
6 Napier Road #04-18
Gleneagles Medical Centre

Singapore 258499
Tel : (65) 6472 4337
Fax : (65) 6472 0691
Email : info@leongkenghong.com
Website :