Early markers for Sjögren's syndrome often begin with persistent dryness (eyes, mouth, skin, throat, vagina) and fatigue, followed by joint pain, swollen salivary glands, and sometimes a chronic dry cough, indicating the immune system attacking moisture-producing glands, with blood tests looking for specific autoantibodies like anti-SSA/Ro and anti-SSB/La being crucial for confirming the autoimmune nature.
SS-A (or Ro) and SS-B (or La): Marker antibodies for Sjögren's. 70% of Sjögren's patients are positive for SS-A and 40% are positive for SS-B. Also found in lupus patients.
EARLY BIOMARKER TESTS ARE AVAILABLE
Their efforts resulted in the development of a panel of tests for antibodies to carbonic anhydrase-VI, parotid salivary protein, and secretory protein-1, all of which have been associated with early Sjögren syndrome.
Gastrointestinal disease in SS may occur in one quarter of the patients and include dysphagia, gastritis, motility disorders, pancreatitis, pancreatic insufficiency, pernicious anemia, autoimmune hepatitis and symptoms consistent with irritable bowel syndrome (IBS), abdominal pain, diarrhea, constipation, bloating, ...
Gastrointestinal (GI) Symptoms in Sjögren's
Dysautonomia can cause impairment of muscle movement in the esophagus, colon, intestines, and stomach leading to common symptoms like impaired swallowing, nausea, constipation, gastroparesis (delayed gastric emptying), and more.
Sjögren's syndrome is an autoimmune disease. These happen when your immune system damages your body instead of protecting it. Experts aren't sure what makes your immune system attack your glands and cause Sjögren's syndrome. Primary Sjögren's syndrome happens with no known trigger or cause.
Specific Tests for Sjögren's Syndrome
Your doctor may recommend some or all of the following tests: Blood and urine tests, to look for the presence of antibodies common in Sjögren's syndrome. The results of an ANA (antinuclear antibody) test will determine if you have an autoimmune disorder.
Positive ANA test results of 1:80 and 1:160 may be seen in up to 15% and 5% of healthy individuals, respectively. A negative ANA test does not exclude the diagnosis of Sjögren's disease; some of these individuals may still have SS-A and/or SS-B antibodies.
80 percent of those with Sjogren's test positive for antinuclear antibodies (ANA). Rheumatoid factor is present in 75- 95 percent of those with Sjogren's. Elevated protein levels will be seen in 80 percent of those with Sjogren's.
(61) studied immunoglobulin profiles in pSS and SLE patients. They showed that in pSS, IgG1, IgG2, and IgG3 were usually increased among the subclasses of immunoglobulin G, while there was a visible and significant reduced level of IgG4 in the sera of pSS patients and a decrease of the IgG4 to IgG ratio.
Sjogren's (SHOW-grins) syndrome is a disorder of your immune system identified by its two most common symptoms — dry eyes and a dry mouth. The condition often accompanies other immune system disorders, such as rheumatoid arthritis and lupus.
Clinical History
Dryness of the eyes (xerophthalmia) and mouth (xerostomia) almost always occurs in patients with Sjögren syndrome, though symptom severity ranges from very mild to debilitating.
Sjögren syndrome is a chronic systemic rheumatic disease that is characterized by excessive dryness of the eyes, mouth, and other mucous membranes. White blood cells damage glands that make moisture, and sometimes other organs can be damaged. Dry mouth and dry eyes are the hallmark symptoms of this syndrome.
Common symptoms of autoimmune disease include:
Your doctors may not have heard about these antibodies, but you can show them this website about the panel. The panel includes the early Sjögren's antibodies (SP-1, CA-6 and PSP), with an option to include commonly tested Sjögren's antibodies (SS-A, SS-B, ANA, RF). Your insurance company may cover the test.
Cholinergic agonists help to stimulate secretions in the body. For dry eye and dry mouth, doctors may prescribe pilocarpine hydrochloride or cevimeline, both of which stimulate the lacrimal glands to produce more tears and the salivary glands to create more saliva. Both medications are taken by mouth three times a day.
Diagnosis of Sjögren's syndrome
Although minor salivary gland biopsy has been traditionally considered "the gold standard" for the diagnosis of SS, newer criteria have emerged to assist on this disease identification.
Many of the autoimmune diseases that overlap with Sjögren's can cause the same symptoms. For example, overlapping diseases like lupus and rheumatoid arthritis can also cause fatigue or joint pain — symptoms that are common in Sjögren's. These similarities can make it challenging to diagnose overlapping diseases.
You may experience dryness in your nose or throat or on your skin. Sjögren's syndrome can also affect the joints, lungs, kidneys, blood vessels, digestive organs and nerves, causing symptoms such as: Swollen glands, specifically behind the jaw and in front of the ears. Joint pain, swelling or stiffness.
Erythrocyte Sedimentation Rate (ESR)
Like CRP, ESR is a non-specific inflammatory marker. Unlike CRP, 20%-40% of people with Sjogren's have an elevated ESR caused by Sjogren's- related immune system dysfunction. However, just like CRP, ESR does not reflect overall disease activity or inflammation.
Joint pain is one of the most common symptoms of Sjögren's disease. Multiple joints are painful, usually episodically with periods of joint pain, known as “flares”, followed by periods of little or no joint pain. Tenderness and swelling of the joints, when present, are indicative of inflammatory arthritis.
The presence of Sjögren's disease appears to aggravate the symptoms of vaginal atrophy. This may be manifested by thinning of the pubic hair, loss of vaginal rugae, decreased vaginal moisture, and narrowing of the vaginal introitus.
Lifestyle factors
Identifying and minimizing stressors is another important aspect of living well with Sjogren's. Chronic stress can trigger flare-ups. Having a good support system can make a tremendous difference when living with a chronic illness.