Sjögren’s Syndrome in Clinical Practice by Graham Hughes, Shirish Sangle, Simon Bowman

By Graham Hughes, Shirish Sangle, Simon Bowman

Sjögren’s syndrome is now thought of pivotal within the spectrum of auto-immune issues. It offers in quite a few guises, together with fatigue, aches and pains, meals and different asthma and never unusually is usually misdiagnosed as, for instance, ‘fibromyalgia, ‘M.E.’, glandular fever and so on. It additionally often overlaps with different auto-immune stipulations resembling hypothyroidism (Hashimotos), Hughes Syndrome and coeliac affliction. prognosis is mainly very important because it frequently responds to remedy, particularly with quinine derivatives (Plaquenil).

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There are a few case reports suggesting that the volume of acid secretion in the stomach is quite low and in a few patients no gastric secretion (achlorhydria) was also reported. In practice, this does not appear to have proved a common problem. G. 1007/978-3-319-06059-0_6, © Springer International Publishing Switzerland 2014 27 28 Chapter 6. Gut Small and Large Bowel Again, Sjögren’s syndrome seems to cause few major bowel problems. However, some of the diseases often associated with Sjögren’s syndrome, can and do cause bowel symptoms – some of these are listed: Coeliac Disease Coeliac disease, another of the auto-immune disorders, is associated with Sjögren’s syndrome.

It is interesting to find that many patients with lupus and with Sjögrens have low vitamin D levels (the accepted normal level is above 75 units). Important, because vitamin D is not just for bones, but is now known to be required for a healthy immune response. G. 1007/978-3-319-06059-0_12, © Springer International Publishing Switzerland 2014 53 54 Chapter 12. General Treatment Diet Sjögrens does seem to be a condition in which food ‘allergies’ (or food intolerances) are common. Sensitivity to wheat has already been mentioned, but many patients give clear histories of intolerance to other foods and drinks.

So, so important, as preventive treatment such as aspirin or even warfarin can be life changing (see Chap. 11) Livedo 25 Neonatal lupus: Mothers with positive anti-Ro antibodies may pass the antibodies through placenta to the infant causing ‘target’ shaped skin lesions (neonatal lupus) in the new born (see Chap. 11). These rashes are generally self-limiting and disappear within 6 months. This does not mean that the child has lupus or Sjögren’s syndrome. Chapter 6 Gut Swallowing The mouth dryness and lack of saliva can lead to difficulties in swallowing – especially of dry food.

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