Sjogren’s Syndrome, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

Sjogren’s syndrome is a medical disorder that most frequently produces dry eyes and mouth.

It is a form of autoimmune disease.

It can be Primary and Secondary if it occurs with other autoimmune diseases:

1. Rheumatoid arthritis
2. Systemic lupus erythematosus.
3. Scleroderma

There is lymphocytic invasion of exocrine glands, inducing the main symptoms of:
1. Xerophthalmia (dry eyes),
2. Xerostomia (dry mouth) and
3. Enlargement of the parotid glands

The causes are

1. Genetic:
There is a genetic predisposition for the disorder but the HLA link changes among ethnic groups.
2. Development of complications such as neuropathy and lymphoma may tend to be common in patients with vitamin D deficiency.

Nine out of ten people who have the disorder are women.
People normally first begin noticing symptoms when they are in their 30s or 40s.

Symptoms are:
1. Dry mouth
2. Dry Eyes
3. Dry mouth

Other symptoms may be:

1. Fatigue
2. Fever
3. Change in the color of hands or feet
4. Joint pain or joint swelling
5. Swollen glands

Autoimmune screening tests may then show a positive rheumatoid factor and antinuclear antibodies

Dryness of the mucosa of the trachea and bronchi may manifest as a dry cough

The dryness of the pharynx and esophagus may cause difficulty in swallowing, and lack of saliva and secretions may predispose to gastro-esophageal reflux

There can be dry skin and vaginal dryness causing dyspareunia

Disease of the pancreas can lead to malabsorption and even acute pancreatitis or chronic pancreatitis but a frequent cause of raised serum amylase is parotitis.

Fatigue is a common feature

About 20% have Raynaud's phenomenon.

The treatment is to relieve the symptoms as there is no cure.

1. Dry eyes may be treated with artificial tears, eye-lubricating ointments, or cyclosporine eye drop

2. Other medicines may be:

a. Steroids: these are tablets taken by mouth that assist to decrease inflammation.
They may be given if the symptoms are particularly bad.

b. Immunosuppressive agents: these are medicines that suppress the abnormal antibody production in Sjogren’s syndrome
Medicines are methotrexate, penicillamine and hydroxychloroquine.

Sjogren’s syndrome is not normally life-threatening.

TABLE OF CONTENT
Introduction
Chapter 1 Sjogren’s Syndrome
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Rheumatoid Arthritis
Chapter 8 Dry Eyes
Epilogue

• Language: English
• Publisher: Kenneth Kee
• Release date: Sep 20, 2016
• ISBN: 9781370034994

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Sjogren’s Syndrome,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2016 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes the Sjogren’s Syndrome, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Sjogren’s Syndrome)

This eBook is licensed for the personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Condition) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Conditions into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 700 amazon kindle books and some into Smashwords.com eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical conditions.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring you the latest information about a condition or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Sjogren Syndrome

What is Sjogren’s syndrome?

Sjogren’s syndrome is a medical disorder that most frequently produces dry eyes and mouth.

Sjogren syndrome is an autoimmune disorder in which the secretory glands that form tears and saliva are damaged.

This disorder produces dry mouth and dry eyes.

The disorder may involve other parts of the body, such as the kidneys and lungs.

It can also involve other organs such as skin and the nervous system

It is a form of autoimmune disease.

Normally, the body makes antibodies to counter infections.

These antibodies help to destroy the cells of the germs (bacteria or viruses) producing the infection.

In autoimmune disorders the body makes the same antibodies (auto-antibodies) that counter its normal cells.

What is the cause of Sjogren’s syndrome?

Pathogenesis:

The exact cause of Sjogren syndrome is not known.

It is believed to be an autoimmune disorder.

This means the body attacks its own healthy tissue by mistake.

The syndrome happens most often in women ages 40 to 50.

It is infrequent in children.

In Sjogren’s syndrome, these auto-antibodies attack the cells of certain glands.

The result is that these glands cannot secrete their normal secretions.

This indicates that the symptoms of Sjogren’s syndrome are mainly due to dryness and lack of gland secretions

Types of Sjogren syndrome

The disease is called

1. Primary if it develops in isolation and

2. Secondary if it occurs with other autoimmune diseases - normally rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) or scleroderma.

Primary Sjogren’s syndrome:

This describes Sjogren’s syndrome which occurs by itself.

About one in a thousand people suffer from it.

Present thinking has identified a host of factors (e.g., immunological, genetic, hormonal and inflammatory) that may be involved in causing the primary syndrome.

One theory is that inflammation or poor function of the exocrine glands results in an autoimmune reaction.

Secondary Sjogren’s syndrome:

This describes Sjogren’s syndrome which happens together with other autoimmune disease such as: 1. Rheumatoid arthritis

2. Systemic lupus erythematosus.

3. Scleroderma

4. Poliomyositis

There is lymphocytic invasion of exocrine glands, inducing the main symptoms of:

1. Xerophthalmia (dry eyes),

2. Xerostomia (dry mouth) and

3. Enlargement of the parotid glands

Causes:

1. Genetic:

There are no chromosomal regions identified by linkage studies (e.g., twin studies) which show definitive proof of a genetic component but circumstantial data is in favor of a genetic cause.

There is a genetic predisposition for the disorder but the HLA link changes among ethnic groups.

2. Development of complications such as neuropathy and lymphoma may tend to be common in patients with vitamin D deficiency.

Incidence

Nine out of ten people who have the disorder are women.

People normally first begin noticing symptoms when they are in their 30s or 40s

Studies of the epidemiology of Sjogren's syndrome document an incidence between 0.4 and