Sjögren’s syndrome: still not fully understood disease

Maślińska, Maria; Przygodzka, Małgorzata; Kwiatkowska, Brygida; Sikorska-Siudek, Katarzyna

doi:10.1007/s00296-014-3072-5

Cited by 68 publications

(61 citation statements)

References 43 publications

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“…There is also a delay of several years between the beginning of the symptoms and the diagnosis [5]. More recent studies confirm it's more common in women that in men (ratio 9:1), mainly between 40 and 60 years, and its more frequent around 50 years old [6].…”

Section: Introductionmentioning

confidence: 68%

Primary Sjӧgren’s Syndrome and Oral Cavity Disorders

Soares¹

2017

IJDM

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Sjögren's Syndrome (SS) is one of the three most common autoimmune diseases in the world, which affects the exocrine glands, specifically the salivary and lacrimal glands. Primary SS (pSS) particularly affects only the exocrine glands, while secondary SS is associated with other systemic autoimmune pathologies. SS is characterized, histopathologically, by an inflammatory lymphocytic infiltrate that interferes with the normal gland function. It affects 0, 5% of the world population, being more common in women (9:1 versus men), mainly around 50 years old, after the menopause. The medical dentist role is very important in the diagnosis of pSS, as in most cases he is the one who detects the first symptoms, in particular dry mouth or xerostomia. The primary syndrome doesn't have a painful development, being dry mouth and eye dryness the most prominent clinical characteristics. The majority of the oral evidences are consequence of salivary glands hypofunction: dental caries, periodontal disease or fungal infections. Along with hyposalivation and xerostomia communication disorders can occur like dysphagia and pharyngeal dryness leading to difficulties in speech and voice fatigue. These last ones have a negative impact in the patients quality of life although a large percentage don't seek professional help. There is a need for awareness of the voice disorders associate with pSS referring the patients to proper professional help. The treatment of pSS is empirical, symptomatic and aimed at dealing with the complications during the early-stages of the disease consisting of limiting the xerostomia and xerophthalmia damages.

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Section: Introductionmentioning

confidence: 68%

Primary Sjӧgren’s Syndrome and Oral Cavity Disorders

Soares¹

2017

IJDM

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“…In addition to the dendritic cells hypothesis stated in the Introduction, 12,13,26 chronic insomnia is likely to affect the regulation of signaling pathways related to the immune system. 27 Further research including molecular epidemiology and prospective studies are necessary to confirm whether chronic insomnia is a risk factor for pSS.…”

Section: Discussionmentioning

confidence: 99%

Risk of Autoimmune Disease in Adults with Chronic Insomnia Requiring Sleep-Inducing Pills: A Population-Based Longitudinal Study

et al. 2016

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BACKGROUND: Recent studies indicate that chronic insomnia is associated with the development of certain somatic diseases. Whether it would be associated with the development of an autoimmune disease (AID) was unknown. OBJECTIVE: We aimed to examine the association and quantify the magnitude of risk for AID in individuals suffering from chronic insomnia requiring sleep-inducing pills. DESIGN: This was a population-based, nationwide longitudinal study. PARTICIPANTS: Using a claims data set containing 1 million randomly sampled, insured subjects derived from the National Health Insurance Research Database, we assembled a chronic insomnia group and a 1:3 propensity score-matched comparison group (CP), which were balanced in terms of sex, age, insurance premium, urbanization, alcohol use disorder, smoking-related diagnoses, and morbid obesity. MAIN MEASURES: Person-time data with incidence rate, adjusted hazard ratios (aHR) by the Cox model, AID-free survival functions compared with the log-rank test, and a sensitivity analysis on the time lag effect were presented. Incident AID within the first year of follow-up were excluded. The error rate was controlled using the BenjaminiHochberg procedure. KEY RESULTS: With 39,550 and 129,914 person-years' follow-up for the chronic insomnia and CP groups (n = 5,736 and 17,208), respectively, we found an increased risk for subsequent AID, representing a 70 % increase in the aHR (1.7; 95 % confidence interval [CI], 1.5-1.9, p < 0.0001). A positive association between chronic insomnia and primary Sjögren's syndrome (pSS) was observed (aHR, 1.3; 95 % CI, 1.1-1.6). Sensitivity analysis disclosed that AID risk was even stronger after 5 years of follow-up (aHR, 2.0; 95 % CI, 1.7-2.4). CONCLUSION:Chronic insomnia requiring sleepinducing pills may be associated with a 70 % increased risk for future AID, particularly pSS.KEY WORDS: chronic insomnia; autoimmune disease; population-based study; propensity score matching; Sjögren's syndrome.

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“…11 In this case, despite seronegative antiRo and anti-La, there were clinical, imaging, and histological findings that allowed the diagnosis of SS. Although antimitochondrial antibodies are characteristic of primary biliary cirrhosis, it is known that their presence in SS patients can occur, presenting a higher risk of liver involvement, 12 which increases the importance of surveillance by a multidisciplinary team. Systemic corticosteroids should be initiated as soon as possible since the prognosis is time dependent.…”

Section: Discussionmentioning

confidence: 99%