DRY EYES AND FATIGUE

What is the commonest cause for these symptoms?

These symptoms constitute the Sicca syndrome. On a background of parotid enlargement, raised ESR, positive ANA test, and positive Rheumatoid factor test, this is most likely to be primary Sjogren’s disease. This is a form of autoimmune dis-order or connective tissue disorder.

What are the other disorders that can cause symptoms of parotid gland enlargement and exhaustion?

Bilateral parotid gland enlargement can occur in viral infections like mumps, HIV, and Cytomegalovirus diseases. Sarcoidosis, Sjogren’s disease, Diabetes, alcohol abuse, chronic renal failure, and high cholesterol and triglycerides can be associated with parotid enlargement.

How do we assess the resenting problem?

We need to ask if the person has a gritty sensation in the eyes. Soreness of the eyes is another symptom. Many have difficulty swallowing dry food. If liquids are necessary to aid swallowing need to be enquired about.

What are the other symptoms of Sjogren’s syndrome?

Joint pains and swelling can be a part of Sjogren’s disease. Some may have bluish discoloration of hands and fingertips on exposure to cold. This is known as Reynaud’s phenomenon. Some dots like rashes could be seen in about 30% of individuals. Sjogren’s disease is an ailment in middle-aged women with fatigue, dry mouth, dry eyes, and bilateral parotid gland swelling. This is known as Sicca syndrome, These individuals have a lot of discomfort and need proper evaluation and treatment for their ailment.

Do all women with Sjogren’s disease have symptoms?

In many women, the disease could be without symptoms. It may manifest only with high ESR, accompanied by high levels of gamma globulin and antibodies to RO and La antigens.

What are the usual findings in a patient with Sjogren’s disease?

Congestion of eyes with dried secretions, dry mouth, dental caries, Fewness behind earlobes as a result of parotid gland enlargement, rash on lower limbs, joint swelling and pain, breathlessness due to lung fibrosis, chronic liver disease, and affection of nerves and trigeminal neuralgia is a known presentation of the ailment.

What are investigations carried out to diagnose Sjogren’s disease?

Certain tests assess tear secretions from the eyes. Staining of the cornea by rose Bengal stain. Checking ANA and anti-hero and La antibodies is important. In some cases, a salivary gland biopsy is necessary. Thyroid function tests, RA factor, and Complement levels are usually normal. Some individuals may have low potassium in their blood.

What is general management?

Treatment is typically symptomatic. Artificial tears, sugar-free chewing gums, meticulous dental hygiene, and avoiding diuretics are significant. Dry eyes, dry mouth, parotid gland enlargement, and joint pains occur together in an individual, then Sjogren’s disease is a possibility. Young women are generally affected. There is unfortunately no curative treatment. Close follow-up is necessary to look for neoplasms to which they are more susceptible.

Categories : Health

Dr Jay Deshmukh is Chief Physician and Director, Sunflower Hospital, Nagpur Honorary Physician to Honorable Governor of Maharashtra and PondicherryCentral. Dr Jay Deshmukh is an M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD From Internal Medicine – Bombay and New Delhi.

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