Sicca syndrome 乾燥症(英文)
Sicca syndrome 乾燥症(英文)
Sicca syndrome, also known as Sjögren syndrome, is a chronic inflammatory disease that most frequently affect the functions of lacrimal gland and saliva gland. Sicca syndrome can be divided into primary and secondary sicca syndrome with a ratio of 50% respectively.
Primary sicca syndrome refers to the patients with sicca syndrome but without the complication of other rheumatic diseases.
Secondary sicca syndrome refers to patients with not only sicca syndrome but also the complication of other rheumatic diseases such as rheumatoid arthritis, systemic lupus erythematosus (SLE), scleroderma, dermatomyositis, or polymyositis.
The cause of sicca syndrome is currently still unknown but is known for relation with autoimmune dysfunction because the functions of lacrimal gland and saliva gland will drop due to attack by the autoimmunity system.
Common Clinical symptoms of Sicci syndrome
Xerostomia: Patients often feel dry mouth and need to drink lots of water. Patients sometimes could wake up at midnight due to dry mouth, affecting the sleep of patients. In some severe cases, patients will cough nonstop due to dry throat or dry bronchitis.
Xerophthalmia: the patients not only have less tear but also have more common symptoms such as foreign articles in the eyes.
Others: Some patients will have dry skin or dry vagina.
Sicca syndrome not only lower exocrine gland function, and produce dry mouth and xerophthalmia but also could result in full body systematic invasion such as affecting the musculoskeletal system ( arthralgia or arthritis ), respiratory system ( Interstitial Lung Disease ), renal and urinary system ( Interstitial cystitis ), and nerve system.
Sicci Syndrome Treatment
Drink more water and pay attention to oral hygiene.
Eat dried plum or sugar-free gum as well as other food that stimulates the secretion of saliva gland.
Parasympathomimetics: Can promote saliva gland secretion such as pilocarpine ( Salagen ) or cevimeline ( evoxac ).
The priority of treatment for sicca syndrome places is projected on reducing syndromes. Patients can change lifestyle and the environment, avoid long-term stay in dry environment, drink more water or chew gum to reduce symptoms of dry mouth.
Patients with serious xerostomia symptoms should avoid food that is too dry or should eat with drinks or soup.
Artificial tears can improve symptoms of dry eyes. Some optometrists increase the time for tears to stay in the eyes through nasolacrimal duct blocking, which can also improve the symptoms of xerophthalmia in patients. Moreover, eye drops containing immunosuppressor is effective for reducing the inflammation of lacrimal gland, and thereby improve the problems with deficient tear secretion.
Some patients with severe xerostomia might need some medicines to directly stimulate saliva secretion, such as pilocarpine, in order to improve the symptoms.
Some female patients will suffer pain in sexual intercourse due to dry vagina and can use lubricant for improvement.
Disease-modifying anti-rheumatic drugs ( also known as DMARD ) such as hydroxychloroquine ( Plaquenil ) can reduce the production of autoantibody and lower excess immunoglobulin.
If the patients suffer from severe full-body inflammation or the function of other major organs are affected, the patients will need to frequently take steroids or other immunosuppressor to improve the condition of disease.
Except for the annoying xerostomia and xerophthalmia symptoms, most patients of sicca syndrome will not face with other major health problems and live like normal people. However s small number of sicca syndrome patients will have complicated arthritis, interstitial pneumonia, hepatitis, cutaneous vasculitis, Neuritis, and even Lymphoma as well as other severe systematic lesion. Hence early and routine follow-up with physicians of special subject in addition to routinely taking some complications testing will discover these severe systematic lesions early and possibly take early treatment. It is quite important for patients of sicca syndrome.
Sicca syndromes are categorized as severe disease under the regulations of national health insurance. Currently there is no real treatment that can solve the root-cause of sicca syndrome. However once accepting the correct treatment, most patients will improve the symptoms and live like normal people. Some patients’ symptoms may completely disappear.
Early diagnosis, living style and environment change, as well as full cooperation with physicians will be the key factor of improvement and prevention.