What is Sjogren's Syndrome
Sjogren's disease - systemic autoimmunedisease relating to diffuse diseases of the connective tissue; It characterized by lesions of many secreting glands, mainly salivary and lacrimal. There are also Sjogren's syndrome (failure of lacrimal glands to the development of keratoconjunctivitis sicca and salivary glands Mumps type) accompanying rheumatoid arthritis, diffuse connective tissue diseases, hepatobiliary diseases and other autoimmune diseases.
Permanent signs of lesions of the lacrimal glands inShegren is to reduce the secretion of tear fluid. Patients complain of a burning sensation, "crack" and "sand" in the eyes. Often marked itching eyelids, redness, congestion in the corners of the viscous white discharge.
Later appear photophobia, eye narrowing gaps, reduced visual acuity.
The second mandatory and permanent feature is the defeat of the salivary glands.
It is characterized by enlargement of the salivary glands. Often, before the advent of these signs are marked dryness of the red portion of the lips, perleches, stomatitis, increase in regional lymph nodes, multiple dental caries.
In the initial stage of the disease xerostomiaonly appears during exercise and excitement. In severe stage of dryness in the mouth becomes constant, it is accompanied by the need to wash down the dry food, the desire to moisten your mouth while talking. Free little saliva, it is frothy or sticky. Tongue dry. The lips are covered with crusts
Dryness of the nose and throat to form a dry crust innose, eustachian tubes in the lumen can cause deafness and temporal development of otitis. Dryness of the throat and vocal cords causes hoarseness. A common feature is the dryness of the skin. Sweating may be reduced. Dry throat, tickling and scratching, dry cough and shortness of breath are common complaints.
How is the treatment of Sjögren's syndrome
The main place in the treatment of Sjögren's syndrome belongs to corticosteroids and cytotoxic immunosuppressants (hlorbutin, cyclophosphamide).
In the initial stage of the disease it is advisableprolonged treatment with prednisolone at low doses (5-10 mg / day). In severe and late stages of the disease should be the appointment of prednisone (5-10 mg / day) and chlorambucil (2-4 mg / day) followed by a longer, for several years, taking maintenance doses of prednisolone (5 mg / day) and chlorambucil (6 -14 mg / week).
Pulse therapy with high doses of prednisone andcyclophosphamide (1000 mg 6-methylprednisolone intravenously daily for three consecutive days and a single intravenous administration of 1000 mg cyclophosphamide) followed by transfer to moderate doses of prednisolone (30-40 mg / day) and cytostatic (hlorbutin 4-6 mg / day or cyclophosphamide 200 mg intramuscularly 1-2 times per week) in the absence of hepatotoxic effects is the most effective treatment for patients with severe manifestations
Assign artificial tears.
With therapeutic soft contact lenses are used to protect the purpose of the cornea.
For the prevention of secondary infection furatsilina solutions used (diluted 1: 5000), 0.25% solution of chloramphenicol, ciprofloxacin, and others.
When the nasal mucosa dryness applyfrequent application of isotonic sodium chloride solution (using turundas). Vaginal dryness is reduced when using the potassium iodide-jelly. When dry the trachea and bronchi bromhexine recommended long term administration (8-16 mg three times a day for 2-3 months). If symptoms of chronic gastritis with secretory insufficiency for long periods carried replacement therapy (hydrochloric acid, natural gastric juice pepsidil). Insufficient secretion of pancreatic enzymes requires admission: panzinorma, Creon, festal courses for 2-3 months, or permanently, as is the treatment solkoserilom (2 mL intramuscularly 2 times a day for 15-30 days).