Re: SJOGREN'S SYNDROME CAN ALSO AFFECT EARS, AS WELL AS EYES, ETC.

April 25, 2005

Hmmmm....the ears sound a lot like what I have, but I don't think I

have dry eyes. Dry mouth...oh yeah, especially at night, but I've

attributed that to the plethora of medications I'm on, now. I've

got ADD, HT, arrhythmia, etc. etc. Add to that the vicodin and

ibuprophen I'm practically taking like candy at this point....yikes.

Well, I see Dr. Jerk in two weeks, and a little over a week after

that I get to see a rheumy who is supposedly one of the best. He

specializes in lupus, but I figure if he can't figure out what's

going on, or refer me to someone who can, no one can.

--- In , Joan Arnold <bookster44@h...>

wrote:

> Lupus Association of Tasmania

>

> Sjögren's Syndrome (SS) - Primary and/or Secondary

>

> In Sjögren's syndrome, changes occur in the immune system--the

body's

> defense against disease. In Sjögren's, the immune system lacks the

usual

> controls. This causes white blood cells to invade glands in the

body

> that produce moisture, such as the tear and salivary glands, and

the

> Bartholins glands in the vagina. They can destroy the glands and

cause

> them to stop producing moisture.

>

> Sjögren's Syndrome can occur on its own as a primary condition or

as a

> secondary disease to other autoimmune conditions (lupus,

rheumatoid

> arthritis, scleroderma, fibromyalgia, etc.). In Primary Sjögren's

> Syndrome, the disease occurs without the presence of another

autoimmune

> condition. Secondary Sjögren's, on the other hand, is accompanied

by

> another autoimmune condition and accounts for approximately 50% of

those

> with Sjögren's Syndrome. 25 % of those patients with Systemic

Lupus

> Erythematosus will also develop Sögren's Syndrome as

an " overlapping "

> disorder.

>

> Sjögren's is characterized by dry eyes, dry mouth, swollen lymph

glands,

> dry nose and arthritis (which can be deforming). In addition to

> affecting the eyes, mouth, glands, nose and joints, Sjögren's can

also

> involve the sinuses, ears, skin, vagina, kidneys, GI tract, blood

> vessels, lungs, liver, pancreas, and brain. Generalized symptoms

of the

> condition include fatigue, loss of appetite, low grade fever,

weight

> loss, muscular weakness, and pain. The many symptoms and

manifestations

> of Sjögren's Syndrome are located below.

>

> Those living with Sjögren's Syndrome should enlist the services of

a

> knowledgeable rheumatologist, dentist, ophthalmologist, and if

necessary

> an otolaryngologist. There are many treatments available to treat

> Sjögren's Syndrome. These include Salagen, NSAIDs, Plaquenil,

Prednisone

> and other corticosteroids, artificial tear and saliva products,

> moisturizing/lubricating products, and the use of exercise to help

keep

> joints and muscles flexible and strong..

>

> Sjögren's syndrome can also cause problems in other parts of the

body,

> including the joints, lungs, muscles, kidneys, nerves, thyroid

gland,

> liver, pancreas, stomach, and brain. The causes of this condition

are

> not known. There is some evidence that viral infections, heredity,

and

> hormones may in some way contribute to Sjögren's syndrome.

Sjögren's

> syndrome can affect people of any race and any age. It usually

affects

> women.

>

> Symptoms

>

> In people with no other health problems, the most common early

symptom

> is the onset of severe dry mouth and eyes. In people with

rheumatoid

> arthritis or related conditions such as lupus, dry eyes and mouth

> develop more slowly. In this case, Sjögren's may be difficult to

diagnose.

>

> Sjögren's syndrome affects everyone differently. You may not have

every

> symptom listed here, and you may have only minor problems with

those you

> do have. The symptoms may seem worse at some times than at others.

> Symptoms include:

>

> Dry mouth The mouth normally contains saliva, which aids chewing

and

> swallowing. In people with Sjögren's syndrome, the amount of

saliva is

> much less. This makes chewing, swallowing, and speaking difficult.

It

> may also cause a decreased sense of taste.

>

> Dry eyes Your eyes may feel dry, " gritty, " or " sandy. " They may

burn and

> look red. A thick substance may accumulate in the inner corner of

your

> eyes while you sleep. Your eyes may be more sensitive to sunlight.

If

> not properly treated, Sjögren's syndrome can lead to ulcers of the

> cornea (the clear covering of the eyeball}. On rare occasions,

this can

> cause blindness.

>

> Swollen salivary glands There are three set of glands that produce

> saliva. They're located under your tongue, in the cheeks in front

of

> your ears, and in the back of your mouth. They may feel swollen

and

> tender. This may occur along with a fever. This affects about one-

half

> of people with the disorder. Dental cavities This is a common

problem

> that results from a dry mouth. Saliva fights bacteria and defends

> against cavities. Because you have decreased saliva, your teeth

may

> develop cavities more easily. Dry nose and throat This may make

your

> throat feel dry and tickly. You may have a dry cough and

hoarseness. It

> can also lead to pneumonia, bronchitis, and ear problems

>

> * loss of smell

> * loss of taste

> * rhinitis

> * increased allergic reactions to airborne allergens

> * frequent sinusitis

> * nosebleeds

> * atrophy of the nasal mucosa glands

> * itching

> * burning

> * increased sneezing

>

> Dryness of the vagina

> This can cause painful intercourse for women with Sjögren's

syndrome.

>

> Ears and Eustachian Tubes Symptoms

>

> * increased ear pressure

> * dulled hearing

> * feeling of ear fullness

> * dizziness or vertigo

> * itching of the external ear canal

> * ear dryness

> * frequent ear infections

> * e ar fluid build-up

>

> Fatigue

> Fatigue is a common complaint. You may get easily exhausted

and feel

> tired and worn out.

>

> Gastrointestinal Tract (includes liver, pancreas, intestines,

stomach,

> and esophagus)

>

> * difficulty swallowing

> * decreased motility of the esophagus

> * dry stomach (also known as atrophic gastritis)

> * increased gastroenteritis

> * chronic hepatitis

> * acute pancreatitis

> * celiac disease

> * biliary cirrhosis

> * gastric achlorhydria

>

> Kidney Symptoms:

>

> * kidney atrophy

> * kidney fibrosis

> * renal tube defects

> * nephrogenic diabetes

>

> Lung Symptoms:

>

> * scarring of lung tissue

> * dry lungs (also known as bronchitis sicca)

> * shortness of breath

> * pneumonia and pneumonitis

> * fibrosis

> * infiltrates

> * interstitial lung disease

>

> Nervous System Symptoms:

>

> * peripheral neuropathy

> * polymyositis

> * confusion

> * dizziness or vertigo

> * myopathy

> * cranial and trigeminal neuropathy

> * cerebral vasculitis

> * memory loss

> * seizures

> * multiple sclerosis type symptoms

>

> Vascular System Symptoms:

>

> * hyperviscosity syndrome (thick blood)

> * cryoglobulinemia

> * cutaneous vasculitis

> * vasculitis of the small vessels

> * vasculitis of the medium vessels

> * purpura hemorrhages

>

> Raynaud's phenomenon

>

> Other problems:

> Sjögren's syndrome can affect other parts of the body, such as

blood

> vessels, the nervous system, muscles, skin, and other organs.

This

> can lead to muscle weakness, confusion and memory problems, dry

> skin, and feelings of numbness and tingling.

>

> Sjögren's syndrome can also affect the liver and pancreas. When it

does,

> there is a greater chance for developing cancer of the lymph

tissue.

> Although this is unusual, it is one reason why medical exams and

> continued follow-up are important.

>

> Diagnosis

>

> Your doctor may do several things to find out if you have

Sjögren's

> syndrome. These include:

>

> Physical examination Your doctor will ask you to describe your

symptoms,

> and will look for other symptoms, such as red, itchy eyes; swollen

> salivary glands; a dry, cracked tongue; and enlarged lymph glands

in

> your neck.

>

> Blood tests Tests for specific blood markers can determine if you

have

> Sjögren's syndrome. However, not everyone with Sjögren's has these

markers.

>

> Schirmer test This helps determine how dry your eyes may be. It

involves

> placing a small piece of filter paper under the lower eyelid to

measure

> the amount of tears your eyes produce.

>

> Slit-lamp examination This is a more accurate way to find out if

your

> eyes are dry. In this test, the doctor puts a drop of dye into

your eye

> and examines the eye with a special instrument called a slit lamp.

The

> dye will stain dry or eroded areas of the eye. This test is often

done

> by an ophthalmologist (eye doctor}.

>

> Lip biopsy In this test, the doctor removes a few salivary glands

from

> inside your lip. The tissue is examined under a microscope. The

> appearance of the tissue helps determine if you have Sjögren's

syndrome.

>

> Salivary function tests These measure the actual amount of saliva

you

> produce, to help determine if you have Sjögren's.

>

> Urine tests These may be done to test your kidney function. Chest

X-ray

> This can help detect changes in your lungs.

>

> Sjögren's Syndrome Laboratory Tests Laboratory and test result

findings

> in Sjögren's Syndrome include:

>

> * elevated sed rate

> * positive HLAB8DR3

> * anemia

> * positive HLADR4

> * leukopenia

> * positive Schirmer test

> * hypergammaglobulin

> * positive Slit-Lamp examination

> * positive RA factor

> * positive salivary gland biopsy (also called a lip biopsy)

> * anti-salivary duct antibodies (SSA (Ro) and/or SSB (La))

> * positive salivary gland function test results

> * positive urine tests results

> * anti-nuclear antibodies (positive ANA)

>

> As yet, there is no cure for Sjögren's syndrome. But proper

treatment

> can help relieve symptoms so you can live a comfortable and

productive life.

> The main goal of treatment is to relieve discomfort and lessen the

> effects of the dryness. Since Sjögren's syndrome affects everyone

> differently, your treatment plan will be based on your specific

needs.

>

> Your treatment may include different ways to relieve your

symptoms, such

> as those listed below. If you have arthritis or another condition,

you

> will also want to follow specific treatment for that condition.

>

> See your family doctor and your dentist regularly. Since Sjögren's

> syndrome can affect many parts of the body, regular checkups can

help

> detect and prevent future problems. You may also need regular

check ups

> with an arthritis specialist) and an eye specialist.

>

> For dry mouth:

>

> * Sip fluids throughout the day.

> * Use sugar-free gum or candies to stimulate saliva production.

> * Try saliva substitutes or mouth coating products. They may be

> useful in some people, and are available without a

prescription.

>

> To prevent dental cavities:

>

> * Have frequent dental checkups.

> * Use mouth rinses that contain fluoride.

> * Brush and floss your teeth regularly.

> * Use sugar-free products.

>

> For dry eyes:

>

> * Use artificial tears or eye drops to help relieve the

discomfort

> of dry eyes. Use preservative-free products, if you apply the

> drops more than four times per day.

> * Try lubricating ointments or small, long-acting pellets for

> overnight or long-lasting relief.

> * Your ophthalmologist may recommend a simple operation that

blocks

> tear drainage from your eye.

>

> For dry skin:

>

> * Use moisturizing lotions for sensitive skin.

> * Avoid drafts from air conditioners, heaters, and radiators,

when

> possible.

> * Use a humidifier in your house and at work.

>

> For vaginal dryness:

>

> * Use lubricants made specifically to help vaginal dryness. Do

not

> use petroleum jelly.

>

> Medications:

>

> Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) help

reduce

> joint swelling and stiffness, as well as muscle aches.

> If you have serious complications, your doctor may recommend

stronger

> medicines.

>

> Exercise

>

> Mild exercise, such as walking or swimming, can help keep joints

and

> muscles flexible. Exercise may also protect against further joint

damage.

>

> A note about pregnancy:

>

> A certain blood marker often found in women with Sjögren's

syndrome can,

> very rarely, be associated with heart problems in newborn babies.

If

> you're a woman with Sjögren's syndrome who is planning to become

> pregnant, see your doctor about testing for this marker. If it is

> present, ask your doctor whether pregnancy is advisable. If you do

> become pregnant, you and your doctor can work out the best plan to

> manage the situation.

>

> Sjögren's syndrome is generally not life-threatening. The outlook

for

> people with this condition is usually good. Dryness, however, may

last

> for the rest of your life. By using artificial moisture and

practicing

> good oral hygiene, you can help prevent serious problems.

> If you have Sjögren's syndrome and a rheumatic disease, make sure

you

> follow your doctor's complete treatment program.

>

> http://users.bigpond.net.au/lupustas/Sjogrens.html

>

April 25, 2005