Sicca Syndrome is a health disorder characterized by improper functioning of the exocrine glands. Read and find out all about this disorder, including its symptoms, causes, diagnosis and treatment.
As aforementioned, it is an abnormal condition marked by impaired functioning of the exocrine glands. The condition is also known as Sjogren ’s syndrome (SS), named after the Swedish ophthalmologist Henrik Sjogren who first described it.
The exocrine glands produce and release hormones into the duct glands. SS blocks the release and production of hormones into the ducle glands. This destroys the balance between the hormones produced by the exocrine and the endocrine glands. The immune cells attack and destroy the endocrine gland which produces tears and saliva. Thus, SS is an autoimmune disorder.
This condition causes dryness of mouth and eyes. However, it can affect various other parts of the body as well.
SS is characterized by two external symptoms, which indicate its presence. These are:
It is marked by a visible decrease in tear production in the eye, causing dry eyes. This condition is known as Keratoconjunctivitis sicca. Dry eyes are very painful and can lead to loss of vision in the long run it.
It is also characterized by a noticeable lack in the production of saliva, leading to a condition known as dry mouth or Xerostomia. With the mouth slowly getting dry patients experience difficulties in swallowing. This damages the tissue inside the mouth. There is a constant need to rehydrate the mouth, which is really annoying.
Other prominent symptoms include:
The symptoms of SS are complicated. Naturally, its diagnosis requires conducting several tests. Some of the tests that are usually carried out for the diagnosis of SS include:
It reveals the dryness of eyes. In this test a strip of filter paper is held inside the lower eyelid for duration of 5 minutes. The wetness is then measured with the help of a ruler. If the wetness is less than 5 millimeters of liquid it indicates that the patient suffers from the Sicca Syndrome. A slit-lamp examination can also reveal dryness of the eyes.
These are done to examine if patients have high amount of anti-bodies in the blood such as anti-nuclear antibody and the rheumatoid factor. Both of these antibodies are associated with auto-immune disorders.
Ultrasound examination of the salivary glands reveals a lot about the disease. The parenchyma of the gland has multiple small 2-6 mm hypoechoic lesions which are representations of the lymphocyctic infiltrates. If the disease is advanced, Sialectasis along with calculi would appear in the gland.
Salivary gland function can be tested by collecting saliva for duration of five minutes.
A lip biopsy has the potential of revealing the amount of lymphocytes which have gathered around salivary glands and the scale of damage done to these glands.
It is another reliable test for the disorder. In this test, a contrast agent is injected into the parotid duct. This parotid duct opens from the cheek into the vestibule of the mouth which lies at the opposite of the neck of the upper second molar tooth. The presence of SS is indicated if the agent gets spread throughout the gland in puddles.
The actual cause of the disease is unknown. The syndrome occurs when the immune system of the body starts attacking its healthy tissues. This disease mainly occurs in women aged within 40-50 years. This syndrome occurs along with other autoimmune disorders like:
However, researchers are said to have found one possible cause of SS. They suspect that destruction of tear and salivary glands of people undergoing a face radiation therapy, which is a part of cancer treatment, is a possible cause of the disorder.
Unless SS is treated in time, the normal functioning of the endocrine glands will be disrupted. This would affect the moisture content of various organs in the body and can lead to a varied set of health hazards.
However, no specific cure for this syndrome has been found as yet. Thus, its treatment is generally symptomatic and supportive.
Some of the possible symptomatic treatments for this syndrome include:
Dry eyes can be treated with moisture replacement therapies such as artificial tears, eye-lubricating ointment or cyclosporine liquid. Cyclosporine is available as a prescribed medicine to treat acute problems of dry eye by restraining the inflammation which disrupts the tear secretion. Artificial tear therapy involves placing punctual plugs in the tear drainage ducts to help the tears stay on the ocular surface for a longer time. Patients with more severe problems can wear goggles to increase the local humidity as a relief.
There are prescribed drugs as a remedy for increasing the salivary flow for those experiencing dry mouth symptoms. The drugs Pilocarpine and Cevimeline are a good remedy. Saliva substitutes are also administered as a remedy.
Chewing gum frequently that is sugarless or sipping water throughout the day can be another good remedy for mouth dryness. Severe dental cavities can be cured with by frequently brushing and flossing your teeth.
Disease modifying drugs used for treating rheumatoid arthritis may improve the symptoms of Sicca Syndrome. Drugs such as methotrexate and Hydroxychloroquine are a good option. Individuals with maximum complications can take corticosteroids or immunosuppressive drugs. Symptoms of arthritis can be treated with non-steroidal anti-inflammatory drugs and physical therapy.
Sicca Syndrome itself is usually not life threatening but its prognosis depends on what other diseases a patients suffers from. This disease can cause damage to some vital organs in the body. Researchers are still studying the disorder and trying to improve diagnostic techniques along with finding effective ways to prevent and cure its symptoms.