Four and a half times more female patients. What kind of disease is it
Aug 11, 2024
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▶ Difficulty swallowing food, oral pain, corneal conjunctivitis, eye itchiness, foreign body sensation accompanied
Sjogren syndrome is a chronic autoimmune disease that mainly affects the salivary and tear glands. 98% of patients complain of one or more symptoms of dry eyes or mouth, and 89% develop both symptoms.
Decreased saliva secretion makes it difficult to swallow dry food, and if symptoms worsen, you can't talk for a long time without drinking water, and your mouth feels burning with changes in taste. Dry and red mouth mucosa, cavities and gum disease are identified, and sub-neuronal or sub-neuronal glands are swollen, accompanied by 60% of patients.
Tear gland dysfunction causes corneal conjunctivitis and manifests as photosensitivity, erythema, itchiness, and foreign body sensitivity. Eye symptoms are aggravated by activities of less blinking due to long-term reading, driving, and using computers, and when there is a lot of wind, dust, and smoke.
▶Schogren syndrome patients have doubled in 10 years, 80% of all patients are women in their 40s or older
If dry mouth, eyes, and dry eyes that cannot swallow food without water are more than 3 months old, you can suspect Sjogren syndrome, an autoimmune disease. Sjogren's syndrome occurs mainly in women in their 40s and 50s, and in Korea, women are 14.5 times more common than men.
According to the Health Insurance Review and Assessment Service's big data on health care, the number of people who visited the hospital with Sjogren syndrome doubled in 10 years to 30,051 in 2023, compared to 14,798 in 2013. As of 2023, the number of women in their 40s and older was 24,063, accounting for 80% of all patients.
Professor Kim Se-hee explained that the prevalence of Sjogren syndrome is expected to increase further as it is rapidly changing into an ultra-aging society.
▶Causes of environmental, genetic, immunological factors, etc
Chronic autoimmune disease is not identified as a specific factor but is described as a complex development scenario of environmental factors, genetic factors, and innate and acquired immunity. As environmental factors, various infectious sources, especially viruses, are considered potential triggers for Sjogren syndrome, and are known to activate innate immune responses and increase interferon.
The association between genes and disease development was confirmed, and as an immunological factor, natural killer cells and B cells were proven to increase major cytokines. However, it is known that more than one cause, these various factors affect each other and affect each other in combination, causing disease.
▶ In addition to fatigue, arthritis, vasculitis, pneumonia, and lymphoma are at risk
In patients with Sjogren syndrome, fatigue complains in 70-80% of patients, and chronic extensive pain is common. In addition, arthritis, ring-shaped erythema on the skin, vasculitis, interstitial pneumonia, and neuropathy may be accompanied. Patients with Sjogren syndrome have a high risk of developing lymphoma, but the risk is higher if the tongue is contracted, the salivary gland is continuously enlarged, and there is a wide range of lymphocyte involvement in antibodies and salivary gland biopsy.
Other exocrine gland dysfunction can affect the upper airways, causing chills and coughs, dry skin, and dry skin can cause pain, and pancreatic dysfunction and hypoxia can be caused by decreased secretion function of digestive organs.
Professor Kim Sehee explained that "in the case of mothers with Sjogren's syndrome, when anti-Ro or La antibodies are present, fetal echocardiography monitoring is necessary because neonatal lupus syndrome may occur through the placenta."
▶ Dry mouth and eyes, biopsy, salivary gland test, antibody test, etc
The criteria for classification of Sjogren syndrome must be dry mouth or eye dry for at least three months. In addition, lip salivary gland biopsy, anti-Ro/SSA or anti-La/SSB antibody test, eye staining or shimmer test to confirm tear gland function, and saliva flow measurement test to confirm salivary gland function are performed. However, not all tests are performed, and eye staining or lip salivary gland biopsies are sometimes performed when shimmer tests and saliva flow rate tests show insufficient results. In addition, a salivary gland scan can be performed to help with diagnosis.
▶Dry the oral cavity, proceed with medication, avoid caffeine, smoking, and alcoholic beverages
Currently, Sjogren syndrome is treated with medication to relieve and control dry symptoms, while using artificial tears and artificial saliva to halve dryness. In oral dryness, caffeine, smoking, alcohol drinks should be avoided first, and sinusitis that breathes through the mouth should be treated.
To reduce dry mouth symptoms, you can often drink water or try unsweetened candy or gum. In dry weather, you can use enough humidifiers and try toothpaste containing fluoride and oral sprays.
Drug treatments include choline parasympathetic ganglion promoters such as pilocalfin. However, it is difficult to use when side effects such as sweating and nausea are severe as side effects.
▶Drying eyes, artificial tears and medication + procedures
To improve dry eye symptoms, you should try wearing protective glasses or goggles in a dry, windy environment and limit activities with less blinking for a long time. Drug treatment for dry eye is based on artificial tears and lubricating ointment, and topical steroids and topical cyclosporine are used when inflammation is accompanied. Patients who do not respond to medication may be assisted in procedures such as tearpoint obstruction.
The treatment of Sjogren syndrome is a systemic disease that requires not only rheumatology treatment, but also treatment in connection with ophthalmology, otolaryngology, and dentistry, and depending on symptoms, dermatology, respiratory medicine, gastroenterology, neurology, and obstetrics.
Professor Kim Se-hee said "Since it is a disease that greatly affects the quality of life of patients, if the symptoms of dry mouth and eyes persist for more than 3 months, you should visit a medical institution to be diagnosed."Drugs such as cold medicines, blood pressure medicines, sleeping pills, and antidepressants have ingredients that make dry mouth and eyes worse." Patients with Sjogren syndrome should take it after consulting with their doctor.'
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bellho@sportschosun.com
