What is sicca syndrome?
Sicca syndrome comes from the Latin word sicca, meaning “dry,” it’s a condition that directly affects your immune system.
The term “sicca” refers to ocular or oral dryness.
Sjögren syndrome is an autoimmune disorder that affects the exocrine glands (salivary and lacrimal glands) – it presents numerous symptoms, mainly dry mouth, and dry eye affecting the salivary or lacrimal glands.
Approximately 30% of patients in the United States have Sjogren’s syndrome. Almost half of the patients develop lymphomas which can lead to serious illness. Sjögren syndrome is primary in cases with no underlying rheumatic disorder.
The spectrum of primary Sjogren’s syndrome (Sjogren’s without another autoimmune disease) extends from sicca syndrome and general features to systemic Sjögren’s and B-cell lymphoma.
It can potentially impact the quality of your daily life, and its treatment focuses on symptom relief. There is no cure.
Sicca Syndrome also called Sjogren’s syndrome – can take its toll on any bodily organ which produces moisture, including your eyes, throat, nasal passages, skin, sinuses, and vagina.
It is a systemic autoimmune disease marked by the overproduction of antibodies that actively destroy your tissues.
Sicca syndrome: also known as Sjogren syndrome, classically combines dry eyes, dry mouth, and other connective tissue diseases such as rheumatoid arthritis (most common), lupus, scleroderma, or polymyositis.
Sjogren syndrome is an inflammatory disease of mucous membranes and other body tissues. Inflammation of the glands that produce tears (the lacrimal gland) leads to decreased tears and dry eyes. Inflammation of the glands that produce the saliva in the mouth (salivary glands, including the parotid glands) leads to a dry mouth. The syndrome can consequently be complicated by infections of the eyes, breathing passages, and mouth.
Diagnosis of Sicca syndrome sometimes involves a biopsy of the affected gland.
Note that sicca syndrome accompanies other autoimmune disorders, such as lupus or rheumatoid arthritis.
The mucous membranes and moisture-producing glands in your eyes and mouth (salivary glands) take the brunt of its initial impact, leading to decreased saliva and tear production.
Although sicca can develop at any age, it typically strikes after 40.
About 90% of Sjogren syndrome patients are female, usually middle-aged or older.
Approximately one percent of the U.S. population (about four million people ‒ most adult females) is battling Sicca syndrome.
Primary Sjogren’s syndrome: diagnostic and prognostic value of salivary gland ultrasonography using a simplified scoring system. Arthritis Care Res (Hoboken) 2014; 66 (7):1102–7. [ PubMed ] [ Google Scholar ] 53. Baldini C, Luciano N, Tarantini G, et al.
The American-European Consensus Group proposed a revised version of the European criteria. Ann. Rheum. Dis. 61, 554–558 (2002). CAS PubMed PubMed Central Article Google Scholar van Woerkom, J. M. et al.
Dry skin and Dry Eye Symptoms – Do I have sicca?
Dry skin and dry eye symptoms occur at least 30% in older adults, especially women.
This condition is caused by several reasons, including medication interactions and side effects.
Sicca syndrome is accompanied by ocular and oral dryness measurements that a physician in the hospital may perform.
Sjogren syndrome is the prototypic symptom of dry eyes that primarily affects women during peri- and post-menopausal years. Doctors need to find clinical evidence of autoimmune inflammation in salivary or lacrimal glands.
Dry mouth and eyes are often associated with medication-induced side effects and are common symptomatic in older adults. However, there’s a broad differential diagnosis for all symptoms.
Detailed evaluations are crucial in defining the etiology of illness and the best treatment. SSS is a prototypical condition that produces such symptoms and affects most women during their menopause period.
A sicca manifestation can be diagnosed based on autoimmune diseases either on a serological or pathological basis. Management involves the application of either topical or systemic treatments.
History of Sicca syndrome
Named after the Swedish ophthalmologist discovered it, Sicca syndrome was first reported in a middle-aged female patient displaying sicca symptoms. Nineteen more cases followed, and Henrik Samuel Conrad Sjogren later wrote a doctoral thesis in 1933.
Sjogren’s thesis was not considered of sufficient importance to earn him the title of “docent,” denying him a career in academic medicine. The syndrome he discovered nonetheless came to be accepted around the world.
Overview of Sicca Syndrome
Sjogren Syndrome is an autoimmune disease characterized by the presence of autoantibodies that attack mucus membranes like the salivary glands (causing dry mouth or xerostomia), the lacrimal glands (causing dry eyes aka xerophthalmia or keratoconjunctivitis Sicca), and the joints (causing inflammatory arthritis).
Sicca Sjogren’s Syndrome is associated with various etiologies, including diabetes Mellitus.
Sjogren’s Syndrome -the first-line management includes a lifestyle modification strategy to address the cause where feasible.
Patients with non-Sjögren’s syndrome sicca report poorer general and oral health-related quality of life than patients with Sjögren’s syndrome: European criteria proposed – a cross-sectional study. Tashbayev B, Garen T, Palm Ø, Chen X, Herlofson BB, Young A, Hove LH, Rykke M, Singh PB, Aqrawi LA, Utheim ØA, Utheim TP, Jensen JL. Tashbayev B, et al. Sci Rep. 2020 Feb 7;10(1):2063. DOI: 10.1038/s41598-020-59078-0.
Often a physician will need an expert to diagnose and treat a patient’s health problem with symptoms such as poor vision.
Various artificial saliva & tear substitute products are currently available.
Still, it may be appropriate to test and prescribe multiple products without a direct comparison between the products according to individual patients’ preferences.
- Sjögren’s syndrome (SHOW’-Grenz) belongs to a class systemic autoimmune disease, a rheumatic disease that affects the entire body.
- The most common problems are dry mouth, dry eyes, fatigue, and musculoskeletal pain.
- However, other potential complications include other areas of dryness, internal organ involvement, neurological complications, and lymphomas.
- Ten times as many women as men are diagnosed with Sjögren’s.
- While most often diagnosed in women during middle age or after menopause, Sjögren’s can affect people of any age, including children.
- Younger Sjögren’s syndrome patients often present differently compared to adults.
- Sjögren’s syndrome patients should be monitored closely for risk factors and development of blood cancers, especially non-Hodgkin B cell lymphoma.
- Pregnant Sjögren syndrome patients who are positive for the autoantibody SSA/Ro should seek care from a perinatologist (an obstetrician who manages high-risk pregnancies) and be monitored for signs of fetal heart block.
- About half of those with Sjogren’s syndrome have another autoimmune disease, such as rheumatoid arthritis, lupus, or scleroderma, so patients with other autoimmune disorders should be assessed for signs of Sjogren’s.
- No systemic immunomodulating therapy has been FDA-approved for Sjögren’s syndrome.
- However, many potential treatments are used, and others are being investigated.
- Patients are treated with nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, hydroxychloroquine, and other drugs that calm the immune system.
- Treatments for dryness aim to relieve symptoms and prevent complications such as thrush, other infections, and dental damage.
Infections
Sicca sjogrens syndrome infections are characterized by swollen eyelids, lips, or mouth affecting salivary and lacrimal gland.
Symptoms are lymphocytosis in the salivary glands and lacrimal glands. This chronic inflammation process leads to glandular injury and associated dysfunction during an extended period, which eventually leads to chronic dry eyes and mouth.
Keratoconjunctivitis sicca is a term invented in 1933 by Henrik Sjogren in the hope of identifying the dryness of the eyes associated with the syndrome.
Statistics
According to the 2008 National Arthritis Data Workgroup report (which included the American College of Rheumatology) on the prevalence of rheumatic diseases, Sjögren’s syndrome patients without an accompanying major autoimmune connective tissue disease number between 400,000 and 3.1 million adults and, when including patients who also have another related disease, the prevalence is twice that number.
In treating Sjogren’s syndrome patients, embracing a multidisciplinary team approach and communication with other medical disciplines is critical for optimal management.
Sicca syndrome symptoms
Doctors generally rely on the presence of sicca sjogren’s syndrome symptoms to diagnose the autoimmune disorder. They include:
- Dry eyes that burn, itch, or feel gritty (as if there’s sand in them)
- Oral dryness, which feels like it’s full of cotton, making it difficult to speak, chew, or swallow (Dry Mouth)
In certain instances, sicca syndrome also produces the following warning signs:
- Joint stiffness, pain, and swelling
- Swollen salivary glands (specifically, those located in front of your ears and behind your jaw)
- Dry skin
- Skin rashes (especially after sun exposure)
- Persistent dry cough
- Vaginal dryness
- Chronic fatigue
- Sore or cracked tongue
- Dry nose
- Peeling or dry lips
- Dry or burning throat
- Increased dental decay
- Digestive issues
- Changes in taste or smell
- Yeast infections
- Vision problems (e.g., light sensitivity, blurred vision, corneal damage) – chronic dry eyes
- Nerve damage (e.g., tingling and burning in your hands and feet)
Who can develop sicca syndrome?
Sicca sjogren’s syndrome usually occurs in individuals with one or more of the contributing factors below:
- Gender
Generally speaking, women already have an increased likelihood of autoimmune diseases, representing approximately 75 percent of all cases. Plus, nine out of every 10 Sicca sjogren’s syndrome patients are women.
- Age
More often than not, the diagnosis of sicca sjogren’s syndrome happens after 40.
- Rheumatic disease
Many patients with some variation of rheumatic diseases, such as lupus or rheumatoid arthritis, also experience Sicca syndrome.
Sicca syndrome vs. Sjogren’s syndrome
Sometimes, doctors will try to differentiate between sicca syndrome and Sjogren’s syndrome. Technically, the former causes constant dryness in any part of your body without autoimmune problems.
On the other hand, Sjogren’s syndrome is an autoimmune disorder that demonstrates additional symptoms besides dryness. Furthermore, it’s challenging to diagnose as symptoms vary significantly from one patient to the next.
Lastly, side effects of some medications may mimic signs of Sjogren’s syndrome.
Evaluation of general health-related quality of life SF-36 GHRQoL assessment revealed that the pSS and non-SS groups had significantly reduced QoL compared to the control group.
European Study Group on Classification Criteria for Sjögren’s Syndrome. Classification criteria for Sjögren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis.
Diagnosis of sicca syndrome
Both Sjögren’s syndrome (S.S.) and non-Sjögren’s syndrome (NSS) can present the sicca symptoms of dry eyes and a dry mouth. Patients diagnosed with Sjogren’s syndrome still have to distinct pathological entities that require diagnostic discrimination to determine disease severity.
According to the Sjogren’s Syndrome Foundation, it takes three years to diagnose this condition. Unfortunately, many medical experts overlook it due to the overlap between sicca syndrome symptoms and those associated with allergies, menopause, chronic fatigue syndrome, lupus, or rheumatoid arthritis.
Sjogren syndrome is typically associated with antibodies, antibodies produced by the body directed against various body tissues (autoantibodies). The diagnosis of the syndrome can also be aided by a biopsy of an affected gland.
Your doctor will likely conduct several tests to rule out other diseases before confirming that it’s Sjogren’s syndrome. They include:
Blood tests
Diagnostic blood tests check for:
- Presence of antibodies common in Sjogren’s syndrome
- Levels of certain types of blood cells
- Evidence of inflammatory issues
- Evidence of liver or kidney dysfunction
Eye tests
A Schirmer tear test is used to measure the ocular dryness of your eyes. A small filter paper is placed under your lower eyelid to gauge tear production.
An ophthalmologist specializing in eye disorders utilizes a magnifying device (known as a slit lamp) to examine the surface of your eyes. They then dispense drops into your eyes to better evaluate any damage to your corneas.
The extent of ocular surface staining measures dryness-induced ocular surface damage.
Ninety six percent of people with Sjogren’s syndrome has meibomian gland dysfunction – clogged oil glands on the eyelids.
Imaging tests
A sialogram can detect how much saliva flows into your mouth. Dye is injected into the salivary glands located in front of your ears, then picked up by an X-ray.
Alternatively, salivary scintigraphy is a nuclear medicine test with a similar goal. In this case, a radioactive isotope is injected into your vein. The isotope is tracked over an hour to see how quickly it arrives at your salivary glands.
Biopsies
When Sjogren’s syndrome is suspected, a biopsy may be performed. A small sliver of tissue from the salivary glands in your lip is collected. It’s subsequently examined under a microscope for the presence of inflammatory cell clusters.
Causes of Sjogren’s syndrome
Since Sjogren’s syndrome is one of the autoimmune disorders, it fools your immune system into attacking its tissues and cells. However, scientists remain unclear about precisely what causes Sjogren’s syndrome.
Genetics might play a role for some, but research shows another mechanism must also trigger it. For example, a person with a genetic predisposition toward Sjogren’s syndrome could be triggered by an infection with a particular virus or strain of bacteria.
Inflammation of the oral mucosa glands that produce the saliva in the mouth (salivary glands, including the parotid glands) leads to a dry mouth.
Although it targets the glands that produce tears and saliva, it may spread to other body parts. Your joints, thyroid, lungs, liver, skin, nerves, and kidneys are all susceptible to damage from Sjogren’s syndrome.
Complications of Sicca syndrome
Sicca syndrome has the potential to create other medical issues, such as:
- Eye damage
- Lung infections and scarring, or bronchiectasis
- Pregnancy complications, like a rash or severe infant heart problems
- Increased chance of developing non-Hodgkin’s lymphoma
- Hypothyroidism
Patient Management
Management of Sjogren syndrome requires attention to the epithelial (ocular dryness and oral dryness, glandular enlargement) and extra-glandular manifestations (e.g., arthritis, pneumonitis, nephritis, vasculitis).
After a confirmed diagnosis, sicca syndrome treatment is essential to maintaining your overall quality of life.
Inpatient management of diseases is vital to understanding how it affects life quality. General oral health quality of life is examined using the 46-point short form health surveys and 15-point oral health related quality effects surveys. Qualifying life questionnaires and thorough examination of oral and eye dryness were carried out in patients with primary Sjögren syndrome.
Approximately 90% of sjogren’s syndrome patients are required to receive a systemic supine or ocular whitening solution if they are not having any other type of oral whitening solution available. Patients presenting systemic symptoms like joint pains, skin lesions, and internal organ involvement can also be treated using immunomodulatory treatments. All patients with chronic diseases such as sarcoma must receive regular monitoring. Ophthalmic dryness management varies according to the severity and the response to the treatment. Avoiding wind, smoking, and eye protection are essential to everyone.
Diagnosis of Sjogren syndrome
This diagnosis focuses on salivary or lacrimal gland inflammation. Determine if the disease is primary sjogren’s syndrome or secondary. Secondary sjogren’s syndrome symptoms are typically milder than primary sjogren’s syndrome.
There are now two types of criteria to be applied: a 2004 United States European criteria group and one 2010 American rheumatological college provisional criteria: They also require the individual to demonstrate focal lymphatic sialadenitis with a concentration score of 1.
These two set criteria have excellent consistency.
Despite these limitations, several international consensus criteria are currently being developed in each case.
Dry eyes
Dry eyes are often caused by ocular dryness, ocular irritation such as burning or sneezing and sore throats, and they also feel an unusually uncomfortable tingling.
The symptoms are caused by low moisture or wind gusting and prolonged eye contact, especially during reading.
A less common symptom is blurring vision, over-tearing, and blepharospasm.
Dry eyes are often due to decreased tear production and excessive tear evaporation. It is most common in lacrimal gland and can be caused without lacrimal gland.
Learn how dry eye treatments work
It contains three layers covering the corneas and uncovered conjunctiva: a mucin layer, an aqueous layer, and an outer lipid layer that blocks evaporation to relief ocular dryness.
Lack of water in the water layer may result from decreased lacrimal gland production in Sjogren’s syndrome and excessive evaporation in cases involving reduced thickness in the lipids.
Measures for addressing aqueous deficiencies could include humidifying environments, wearing snout glasses, a nasal evaporator, a punctual plug, and eye cream.
Meibomian gland treatment can include hygienical treatment and massage of limbs or oral antibiotics like doxycycline.
Eye drops
Artificial tears can prolong ocular breakdown and decrease ocular damage.
The lower viscosity drop is designed for quicker evaporation and provides long-term lubrication. However, there have not been enough studies to show that certain products may be better than others.
The over-counter medicine is not as effective as the drug offered only for a limited period or for long periods.
Learn how oral dry eye treatment can help you.
Best Sjogren’s Syndrome relief from TheraLife
Dry Mouth
Oral symptoms: a positive response to at least one of the following questions: Have you had a daily feeling of dry mouth for more than three months? Have you had recurrently or persistently swollen salivary glands as an adult? Do you frequently drink liquids to aid in swallowing dry food?
One of the most frequently used questionnaires is the Oral Health. Evaluation of oral health related quality of life Oral Health-related Quality of Life is defined as “the absence of negative impacts of oral conditions on social life and a positive sense of dentofacial self-confidence.” It has been measured with various instruments 39.
Dry mouth can also impact a person’s general health, nutrition, and quality of life; it may also be the first sign of various chronic diseases.
Mouth dryness has been associated major salivary glands with poor oral health, as indicated by higher rates of dental caries, periodontal diseases, and oral infections; prosthetic problems were also observed in patients with dry mouth.
Burning mouth syndrome
Oral dysaesthesia or burning mouth syndrome A neuropathic disorder causing oral dryness and discomfort without objective reduction in salivary flow. This is not Sjogren’s syndrome.
Xerostomia and salivary hypofunction
Xerostomia is a dry mouth. It causes burns, dry mouth, taste changes, sensitivity, and the feeling of lack of saliva in food.
It may be difficult to speak or swallow, or wear a denture.
It is essential for people with the reduced salivary capacity to ingest water for consuming food. Halitosis or tongue fissures can cause irritated or numb skin and rash. They can occur when swallowing spicy and acidic food due to candidiasis. It is difficult to know how salivation translates to xerostomia.
The prevalence of xerostomia was 88%, (n=112) – 0.94% of the population (n = 8) for Sicca syndrome and 0.24% for Sjogren syndrome.
Xerostomia and Sicca syndrome is an essential component for age-affected individuals. The present study showed that diagnosing the dry mouth symptoms and the Sjogrens’ syndrome is a part of the treatment plan.
Research results
The research involved 626 male and 369 female participants. Xerostomia was 8.0% (n = 112) and a Sicca syndrome was detected for 0.4% (n = 8). The most likely experiencing xerostomia occurred among older females and male subjects with lower educational attainment. Like other groups with Sicca syndromes, female subjects and older subjects also had more systemic disease and used medication.
The current studies have been done using dental clinical procedures during cross-sectional national oral health research. Data collected between 17 & 19 2019 are available. The random cluster test included 35 to 74-year-olds from Lithuania’s largest cities and 11 rural districts. In the predefined locations, the select numbers of participants were derived from the patient lists of primary healthcare providers and invited to join.
How treatments for dry mouth work
Saliva is produced through the parotid, submandibular and sublingual glands continuously and are delivered through sensory inputs from tastes and smells and mechanically through chewing. Salivary stimulating agents help boost saliva production by using either pharmacological or mechanical means such as chewing. Salivary substitutes cover the mucus membrane to prevent saliva evaporation.
Article PubMed Google Scholar Bergdahl M, Bergdahl J. Low unstimulated salivary flow and subjective oral dryness: association with medication, anxiety, depression, and stress. J Dent Res. 2000;79(9):1652–8.
Handling dry mouth
Salivary stimulants work to increase production in those with residual salivary gland function, either pharmacologically or by mechanical action, such as chewing gum.
Some patients have sicca symptoms in the absence of known diseases or medication but without the distinctive features of pSS, namely Ro/SSA and La/SSB autoantibodies and lymphocyte infiltration in their minor salivary glands.
The prevalence of xerostomia remained 8.7% based on aging, city residences, and systemic diseases.
Xerotommia is more common among women in the older age group, among people with systemic illness and taking medicine.
Sjogren Syndrome was diagnosed in 0.24% of people with it.
The study supports the idea that dental professionals can help detect early Sjogren syndrome by training themselves in oral health related quality.
The relation between salivation and xerostomia is complex.
Dawes showed that healthy subjects report dry mouth symptoms when their baseline salivary flow is reduced by 50%, even if the residual salivary flow level remains within the broad range of normal. Saliva is produced by the major (parotid, submandibular, sublingual) and myriad submucosal minor salivary glands. The parotid glands only produce saliva upon gustatory or olfactory stimulation.
Research findings suggest that dentists can uncover suspected Sjogren’s syndrome cases, given they perform a thorough clinical examination. Dental practitioners need to acquire knowledge about mouth dryness and its determinants and learn how to identify xerostomia.
Treatment of dry mouth and other non-ocular sicca symptoms in Sjögren’s syndrome. https://www.uptodate.com/home.
Consider lifestyle measures and health promotion.
Xerostomia is a severe disorder that affects the digestive system mainly.
Dietary sugars or foods that contain acid are dangerous because of their ability to cause infection to develop.
Two times daily, can clean teeth with warm water or fluoride or an antiseptic mouthwash.
Dentures require removal during the night to ensure they can clean according to a physician’s directions.
Patients will need to keep hydrated. Drinking water and sucking ice chips can aid people with high blood pressure.
Vaginal dryness
Vaginal dryness dyspareunia vulvar pruritus is commonly experienced in post-menopausal women, and also in people with Sjogren’s syndrome.
They have been linked with decreased testosterone in menopause.
In 2014 a group of scientists from several countries recommended a definition for menopause symptoms. It may cause genital dryness, burning, irritation, inadequate lubrication, painful intercourse, or another urinary acuity.
Listen to the patient’s experience.
Sicca syndrome is very harmful to patients and affects their quality of life.
Dry mouth can be caused by trouble with taste, occlusion, and swallowing.
Dry eyes cause eye irritation and eye fatigue, and blurry and damaged corneas.
Almost no practitioner is equipped to measure objective amounts of salivary flow or tears.
There are, therefore, appropriate ways of grouping symptoms based on patient reports.
Know when to refer
A second ophthalmologist referral is recommended if patients have moderate or severe eye irritation, photophobia, unilateral redeye, or low vision.
Indications for the non-assisted referral to ophthalmologists include: Intensive medical care must be given to patients with significantly lower oral consumption. A diabetologist and speech therapist will often help with preventing nutritional deficiencies.
Review the patient regularly
In addition, a randomized controlled clinical trial may be conducted to see how the drug works for the onset or prolongation of an uncontrolled period after undergoing treatment and to determine if there are any adverse effects.
Screen for other manifestations of sicca syndrome impacting the quality of life
The symptoms of sicca syndrome can extend to chronic coughing and vaginal dryness in women. These symptoms should be evaluated for a daily check-up with appropriate symptoms.
Screen for other manifestations of sicca syndrome impacting the quality of life
Consider and address underlying causes where possible.
Siccas syndrome is characterized by idiotism and teratogenicity, and is usually secondary. The cause of this disease and related clinical characteristics.
What are autoimmune diseases?
Autoimmune diseases are when your immune system mistakenly attacks your body.
The immune system usually guards against germs like bacteria and viruses. When it senses these foreign invaders, it sends out an army of fighter cells to attack them.
Usually, the immune system can tell the difference between foreign cells and your cells.
In autoimmune diseases, the immune system mistakes parts of your body, like your joints or skin, as foreign. It releases proteins called autoantibodies that attack healthy cells.
Some autoimmune diseases target only one organ. Type 1 diabetes damages the pancreas. Other conditions, like systemic lupus erythematosus (SLE), affect the whole body.
Why does the immune system attack the body?
Doctors don’t know precisely what causes the immune system to misfire.
Yet some people are more likely to get autoimmune diseases than others.
According to a 2014 study, women get autoimmune diseases at about 2 to 1 compared to men — 6.4 percent of women vs. 2.7 percent of men. Often the disease starts during a woman’s childbearing years (ages 15 to 44).
Ethnicity
Some autoimmune diseases are more common in certain ethnic groups. For example, lupus affects more African-American and Hispanic people than Caucasians.
Genetics
Certain autoimmune diseases, like multiple sclerosis and lupus, run in families. Not every family member will necessarily have the same illness, but they inherit a susceptibility to an autoimmune condition.
Environment
Because the incidence of autoimmune diseases is rising, researchers suspect environmental factors like infections and exposure to chemicals or solvents might also be involved.
A “Western diet” is another suspected risk factor for developing autoimmune diseases. Eating high-fat, high-sugar, and highly processed foods are thought to be linked to inflammation, which might set off an immune response. However, this hasn’t been proven.
A 2015 study focused on another theory called the hygiene hypothesis. Because of vaccines and antiseptics, children today aren’t exposed to as many germs as before. The lack of exposure could make their immune system prone to overreact to harmless substances.
BOTTOM LINE: Researchers don’t know exactly what causes autoimmune diseases. Genetics, diet, infections, and exposure to chemicals might be involved.
14 common autoimmune diseases
There are more than 80 different autoimmune diseases that impacts quality of life. Here are 14 of the most common ones.
1. Type 1 diabetes
The pancreas produces the hormone insulin, which helps regulate blood sugar levels. In type 1 diabetes mellitus, the immune system attacks and destroys insulin-producing cells in the pancreas.
High blood sugar results can lead to damage to the blood vessels and organs like the heart, kidneys, eyes, and nerves.
2. Rheumatoid arthritis (R.A.)
In rheumatoid arthritis (R.A.), the immune system attacks the joints. This attack causes redness, warmth, soreness, and stiffness in the joints.
Unlike osteoarthritis, which commonly affects people as they get older, R.A. can start as early as your 30s or sooner.
3. Psoriasis/psoriatic arthritis
Psoriasis causes skin cells to multiply too quickly. The extra cells build up and form inflamed, red patches, commonly with silver-white plaque scales on the skin. Skin cells typically grow and then shed when they’re no longer needed.
Up to 30 percent of people with psoriasis also develop swelling, stiffness, and pain in their joints. This form of the disease is called psoriatic arthritis.
4. Multiple sclerosis
Multiple sclerosis (M.S.) damages the myelin sheath, the protective coating surrounding nerve cells, in your central nervous system. Damage to the myelin sheath slows the transmission speed of messages between your brain and spinal cord to and from the rest of your body.
This damage can lead to symptoms like numbness, weakness, balance issues, and trouble walking. The disease comes in several forms that progress at different rates. According to a 2012 study, Trusted Source, about 50 percent of people with M.S. need help walking within 15 years after the disease starts.
5. Systemic lupus erythematosus (SLE)
Although doctors in the 1800s first described lupus as a skin disease because of the rash it commonly produces, the systemic form, which is most the common, actually affects many organs, including the joints, kidneys, brain, and heart.
Joint pain, fatigue, and rashes are among the most common symptoms.
6. Inflammatory bowel disease
Inflammatory bowel disease (IBD) is a term used to describe conditions that cause inflammation in the intestinal wall lining. Each type of IBD affects a different part of the G.I. tract.
- Crohn’s disease can inflame any part of the G.I. tract, from the mouth to the anus.
- Ulcerative colitis affects only the large intestine (colon) and rectum lining.
7. Addison’s disease
Addison’s disease affects the adrenal glands, which produce the hormones cortisol and aldosterone, and androgen hormones. Having too little cortisol can affect how the body uses and stores carbohydrates and sugar (glucose). The aldosterone deficiency will lead to sodium loss and excess potassium in the bloodstream.
Symptoms include weakness, fatigue, weight loss, and low blood sugar.
8. Graves’ disease
Graves’ disease attacks the thyroid gland in the neck, causing it to produce too much of its hormones. Thyroid hormones control the body’s energy usage, known as metabolism.
Having too many hormones revs up your body’s activities, causing symptoms like nervousness, a fast heartbeat, heat intolerance, and weight loss.
One potential symptom of this disease is bulging eyes, called exophthalmos. It can occur as a part of what is called Graves’ ophthalmopathy, which occurs in around 30 percent of those who have Graves’ disease, according to a 1993 study by trusted Source.
9. Sjögren’s syndrome
This condition attacks the glands that provide lubrication to the eyes and mouth. The hallmark symptoms of Sjögren’s syndrome are dry eyes and dry mouth, but it may also affect the joints or skin.
10. Hashimoto’s thyroiditis
In Hashimoto’s thyroiditis, thyroid hormone production slows to a deficiency. Symptoms include weight gain, sensitivity to cold, fatigue, hair loss, and thyroid swelling (goiter).
11. Myasthenia gravis
Myasthenia gravis affects nerve impulses that help the brain control the muscles. When the communication from nerves to muscles is impaired, signals can’t direct the muscles to contract.
The most common symptom is muscle weakness which worsens with activity and improves with rest. Muscles that control eye movements, eyelid opening, swallowing, and facial movements are often involved.
12. Autoimmune vasculitis
Autoimmune vasculitis happens when the immune system attacks blood vessels. The resulting inflammation narrows the arteries and veins, allowing less blood to flow through them.
13. Pernicious anemia
This condition causes a protein deficiency made by my stomach lining cells, known as an intrinsic factor that is needed for the small intestine to absorb vitamin B-12 from food. Without enough of this vitamin, one will develop anemia, and the body’s ability for proper DNA synthesis will be altered.
Pernicious anemia is more common in older adults. According to a 2012 study, it affects 0.1 percent of people in general but nearly 2 percent of people over 60.
14. Celiac disease
People with celiac disease can’t eat gluten foods, a protein found in wheat, rye, and other grain products. When gluten is in the small intestine, the immune system attacks this part of the gastrointestinal tract and causes inflammation.
A 2015 study trusted Source noted that celiac disease affects about 1 percent of people in the United States. Many people have reported gluten sensitivity, which isn’t autoimmune diseases but can have similar diarrhea and abdominal pain symptoms.
Autoimmune disease symptoms
The early symptoms of many autoimmune diseases are very similar, such as:
- fatigue
- achy muscles
- swelling and redness
- low-grade fever
- trouble concentrating
- numbness and tingling in the hands and feet
- hair loss
- skin rashes
Individual diseases can also have unusual symptoms. For example, type 1 diabetes causes extreme thirst, weight loss, and fatigue. IBD causes belly pain, bloating, and diarrhea.
With autoimmune diseases like psoriasis or R.A., symptoms may come and go. A period of symptoms is called a flare-up. A period when the symptoms go away is called remission.
BOTTOM LINE: Symptoms like fatigue, muscle aches, swelling, and redness could be signs of an autoimmune disease. Symptoms might come and go over time.
Tests that diagnose autoimmune diseases
No single test can diagnose most autoimmune diseases. Your doctor will use a combination of tests, a review of your symptoms, and a physical examination to diagnose you.
The antinuclear antibody test (ANA) is often one of the doctors’ first tests when symptoms suggest an autoimmune disease. A positive test means you may have one of these diseases, but it won’t confirm exactly which one you have or if you have one for sure.
Other tests look for specific autoantibodies produced in certain autoimmune diseases. Your doctor might also do nonspecific tests to check for the inflammation these diseases have in the body.
BOTTOM LINE: A positive ANA blood test may indicate an autoimmune disease. Your doctor can use your symptoms and other tests to confirm the diagnosis.
How are autoimmune diseases treated?
The treatment of Sjogren syndrome is directed toward the particular body areas involved in the disease and the complications such as infection.
Treatments can’t cure autoimmune diseases, but they can control the overactive immune response and bring down inflammation or reduce pain and inflammation. Drugs used to treat these conditions include:
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin, Advil) and naproxen (Naprosyn)
- immune-suppressing drugs
Treatments are also available to relieve symptoms like pain, swelling, fatigue, and skin rashes.
Eating a well-balanced diet and getting regular exercise may also help you feel better.
The treatment of Sjogren syndrome is directed toward the particular body areas involved in the disease and the complications such as infection.
BOTTOM LINE: The primary treatment for autoimmune diseases is medications that bring down inflammation and calm the overactive immune response. Treatments can also help relieve symptoms ,and improve quality of life.
When to see a doctor
See a doctor if you have symptoms of an autoimmune disease. Depending on the type of disease you have, you might need to visit a specialist.
- Rheumatologists treat joint diseases like rheumatoid arthritis and other autoimmune diseases like Sjögren’s syndrome and SLE.
- Gastroenterologists treat diseases of the G.I. tract, such as celiac and Crohn’s disease.
- Endocrinologists treat conditions of the glands, including Graves’ disease, Hashimoto’s thyroiditis, and Addison’s disease.
- Dermatologists treat skin conditions, such as psoriasis.
Consult your physician if you observe any of the above symptoms associated with Sjogren’s syndrome. Even if it’s not sicca syndrome, another underlying issue could require attention. After a confirmed diagnosis, sicca syndrome treatment is essential to maintaining your overall quality of life.
Takeaway
Sjogren’s syndrome is a relatively prevalent autoimmune disease that frequently presents itself in women over 40. It’s tricky to diagnose as it shares several warning signs with other medical conditions. Once diagnosed; however, there are plenty of effective treatment options for alleviating sicca syndrome symptoms, allowing you to live a more comfortable life.
Acknowledgments
Its publication charge is paid by grants from the UiT Arctic University of Norway.
References
Ramos-Cavalls., Tzioufas Ag. G. Stone. Sjogren syndrome treatment: a systematic review. Journal of Physiology, 304, 452–456 (2011). CAS PubMed Article pubmedcentral.com & Favat. Keratoconjunctivitis and buccoglossofaryngitis sicca with the extension on parotid. Archaeologists. Ophthalmologica 36 (2), 275-224 (1947). The Case of Sjogren Syndrome. A systematic review of Sjogren Syndrome and its causes in general. Amer. A. Manages Health 7, S433-2443 (2001). CA: PubMed.
