Sjogren's syndrome- probable therapy?
Hello, our 55-year-old female house help is experiencing inability to eat completely due to loss of teeth. Along with that she also complained of dryness of mouth, since 1 year, and dryness of eyes since 7-8 years. Extraoral examination showed bilateral parotid gland enlargement present on the right and left side of the parotid region. On an inspection – swelling on right and left of the parotid gland, measuring about 2.5 cm × 2 cm in diameter. Surface texture over the swelling was normal. Swelling extending superior up to the inferior border of the mandible at the angle region. Ear lobe was everted on the right side. On palpation it was diffuse, firm, non-movable, warm, tender on palpation, overlying surface texture was normal, along with that dryness of eyes, fever was also noted. Bilateral submandibular lymph nodes were palpable. Ultrasonography shows bilateral submandibular and parotid gland enlargement with multiple hypoechoic lesions within showing very high vascularity, likely to present systemic disorder like Sjögren’s syndrome. I would like to know the probable therapy for this condition.
@udipta Sjögrens syndrome is a defined as a clinical symptom complex. It is an autoimmune destruction of exocrine glands (primary salivary and lacrimal)that produces the clinical manifestations of dry mouth, dry eyes (keratoconjuctivities sicca), and in more than 50% of cases, parotid gland enlargement. Treatment of Sjögren’s syndrome depends on the extent and severity of the clinical manifestations and is better instituted through a multidisciplinary approach. Symptomatic treatment includes artificial tears, salivary substitutes to relieve the symptoms and prevent local infectious complications like conjunctivitis and corneal inflammation, development of caries and periodontal disease, a thorough dental preventive program should be implemented in all cases. Corticosteroid treatment should be reserved for all the cases showing evidence of organ damage, significant leukopenia or severe clinical symptoms.