Introduction
In this case, there is a drying up of salivary gland secretions and lacrimal gland secretions in these patients leading to a dry mouth and dry eyes. For this reason, it is important that these patients use artificial tears to prevent serious corneal damage and blindness. To clarify, dryness can also develop in the skin, the mucous membranes of the nose, throat, upper airways and bronchial tubes and the genitals.
For this reason, there are more frequent bronchitis infections and pneumonias. It must be remembered that the immune system is so seriously altered that Sjögren’s patients have a risk of about 40-fold over the normal risk to develop lymphomas. In effect, pancreatitis is also common as this too is a glandular organ.
Milder arthritis presentation in Sjögren’s syndrome patients
Generally speaking, joint involvement is similar to RA, but the joint swelling and progression of symptoms is much more benign and self-limiting. For the most part treatment is conservative and concentrates on symptomatic control of the symptoms. Care must be taken that the physician does not harm the patient by overzealous therapies. For instance one has to be careful not to overuse corticosteroids and one should not use methotrexate for Sjögren’s syndrome patients as their immune system is already compromised and these therapies could trigger the development of a lymphoma.
Eye Involvement
Episcleritis is an irritation of the conjunctiva with reddening, irritation, light sensitivity, increased tear flow and tenderness. It is self limiting and can also present with some rheumatoid nodules. It does not threaten the vision.
Scleritis
This condition affects the deeper layers of the sclera (the white of the eye). Pain with this condition is so severe that it can interfere with sleep and appetite. There is sensitivity to light, a nodular redness, which in time turns into scarring and thinning of the sclera, which gives it a bluish-grey appearance. This is potentially a threat to vision as the scarring can permanently damage the eye by spontaneous rupture of the eye.
References
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