Why Sjogren's Syndrome Is Underdiagnosed
Sjogren's (SHOW grins) Syndrome is an autoimmune disease in which the body's immune system attacks healthy tissue, mistaking it as a harmful invader. Up to four million Americans may suffer with this disease. It primarily strikes people older than 40 and women are nine times more likely than men to develop Sjogren's.
Sjogren's Syndrome is difficult to diagnose and experts suspect it is under-diagnosed. The symptoms of Sjogren's vary among patients. They also mimic other diseases or the side effects from some medications. Furthermore, there is no one definitive test for diagnosing Sjogren's. According to the Sjogren's Syndrome Foundation, it can take an average of 6.5 years from the onset of symptoms to an accurate diagnosis.
Sjogren's Syndrome tends to affect the mucous membranes and moisture-secreting glands first. The most common symptoms are dry eyes and dry mouth.
Unless we are crying, we normally don't give much thought to our tears. However, they play an important role in nourishing, lubricating, and protecting the eyes. In Sjogren's patients, tear-secreting glands become inflamed, reducing tear production and the composition of tears.
Similarly, Sjogren's Syndrome can cause a decrease in the amount or quality of saliva and lead to xerostomia (zeer oh stomia), or dry mouth. Like tears, saliva protects and preserves your oral cavities and oral functioning. Humans have three major salivary glands and hundreds of minor salivary glands. Not all salivary glands may be affected by Sjogren's, adding to the difficulty of diagnosing this disease. Dry mouth can cause serious oral and dental problems.
Sjogren's Syndrome may also involve other organs, including the lungs, kidneys, nerves, blood vessels, bladder, lymph nodes, liver, pancreas, and gastrointestinal system. Sjogren's patients may have issues with skin or vaginal dryness, difficulties eating, changes in taste or smell, dry nose, fatigue, or joint pain.
Diagnosing Sjogren's Syndrome
Physicians use several diagnostic tools, which may include a biopsy, to evaluate ocular (eye) and oral symptoms. For example, since one of the key manifestations of Sjogren's is a change in the amount and composition of saliva, your physician may measure your salivary flow rate (the amount of saliva produced during a specific amount of time). She may also use scintigraphy to measure the rate at which a small amount of radioactive material is taken up from the blood by salivary glands and secreted to the mouth.
If you suspect you may have Sjogren's Syndrome, see your physician right away. Delaying treatment can lead to serious complications.
Vissink, Arjan, Bootsma, Hendrika, Kroese, Frans G.M, and Kallenberg, Cees G.M. "How to Assess Treatment Efficacy in Sjögren's Syndrome?" Current Opinion in Rheumatology 24(3) (2012): 281-289. Medscape Medical News. Web. 30 April 2012.
Chou, Chung-Tei. "Recent Developments in the Diagnosis and Management of Sjögren's Syndrome." International Journal of Clinical Rheumatology 6(4) (2011): 445-452. Medscape Medical News. Web. 9 September 2011.
Sjogrens Foundation. "About Sjögren's." Web.
Mayo Clinic. "Sjogren's Syndrome." Web. 6 August 2011.
Journal of the American Medical Association. "Sjogren's Syndrome." JAMA 304(4) 2010: 486. Web.
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