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January 30, 2013
The syndrome of Shegren which is also called a syndrome of "dry" mucous membranes most often is diagnosed now for women after forty-year age, that is during this period when there comes the menopause.
In certain cases the disease is shown at young women who suffer from hyperfunction of ovaries. Also this syndrome sometimes accompanies some general diseases. It is shown at a scleroderma, a nodular periarteritis, a sarcoidosis. As the medical statistics testifies, Shegren's syndrome develops at 15–25% of patients with a pseudorheumatism, at 5–10% of the patients having collagenic diseases and also at 50-100% of patients with autoimmune liver illnesses.
This syndrome the first was described in detail in 1933 by the ophthalmologist Shegren from Sweden. Later, in 1965, from the general syndrome the separate illness of Shegren was allocated.
Symptoms of a syndrome of Shegren
Shegren's syndrome is a symptom complex at which signs of defeat of excretory glands are combined with autoimmune diseases. Excretory glands allocate for body surfaces or in its secret: these are salivary, sweat, lacrimal, vulval glands. Symptoms of a syndrome of Shegren are shown by several individual diseases. At a dry keratoconjunctivitis there is an inflammatory defeat of a cornea and conjunctiva of an eye. It is easy to make out this symptom even on a photo. At a keratoconjunctivitis secretion of the lacrimal liquid decreases owing to what patients are constantly disturbed by burning or eye pain. Patients describe these feelings as availability of sand or scratches in eyes. In the course of the movement a century the unpleasant feeling becomes more expressed.
At a xerostomia sialadens because of what there is a dryness in a mouth, and also chronic inflammatory process of parotid sialadens which periodically escalates are surprised. At the same time the patient complains of pain, severe hypostasis, it lifts body temperature. Inflammatory process most often takes both parotid glands.
Except the specified symptoms Shegren's syndrome can be expressed by damage of joints owing to which constraint of joints in the mornings, pain in them is shown. Mainly wrists and fingers on hands are surprised. At the same time process of growth of nails is often broken.
Signs of damage of a gastrointestinal tract can be also observed. First of all, in this case ponosa and dysphagias are noted. Sometimes at the patient symptoms of colitis and chronic pancreatitis are shown. Research of acidity of a gastric juice at Shegren's syndrome confirms decrease in quantity or lack of free hydrochloric acid, and also decrease in allocation of a secret in a stomach and vneshnesekretorny function of a pancreas.
Owing to manifestation of dryness of a mucous trachea and bronchial tubes pulmonary infections can develop. Therefore, the patient suffers from pneumonia and bronchitis.
Are diagnosed as well defeats of other glands. Now Shegren's illness and Shegren's syndrome is included into group of widespread illnesses of connecting fabric. Treatment of a syndrome of Shegren initially assumes therapy of the main illness.
Most often Shegren's syndrome is diagnosed for patients with the system lupus erythematosus having a chronic current and also at a system scleroderma. In most cases Shegren's syndrome develops in several years after the beginning of a basic disease, against the developed clinical picture. Periodic aggravations and remissions are characteristic of an illness.
This syndrome does not exert impact on the course of the main illness but only complicates its therapy, supplementing an autoimmune disease of uncharacteristic signs.
In modern medicine Shegren's illness is allocated as an individual autoimmune general disease at which dryness of mucous membranes, owing to an adenosis is observed. Besides, muscles of a gastrointestinal tract, lungs, and also other bodies are involved in pathological process. The factors provoking a course of a disease are infectious diseases, strong overfatigue, overcooling, tension of psychological character.
Fundamental difference of an illness of Shegren from Shegren's syndrome consists that in the first case at patients the reason of this phenomenon — independent autoimmune diseases is not observed.
Ferruterous and extra ferruterous displays of an illness of Shegren are allocated. Ferruterous manifestations are expressed by depression of function of the cosecreting glands. As well as at Shegren's syndrome, at defeat of the lacrimal glands patients feel burning in eyes, also reddening and an itch is shown a century. After the patient complains of a photophobia, it loses visual acuity, and palpebral fissures are narrowed. The second symptom of this disease — defeat of sialadens owing to which the chronic inflammation develops. Initially at a course of a disease of people notes dryness of lips, emergence of perleches. At it stomatitis, caries of teeth can develop, the located lymph nodes increase close. Approximately at thirds of part of patients increase in parotid glands is observed. In the beginning an illness of manifestation of dryness in a mouth are noted only at strong nervousness or at physical activity. When the illness progresses, and at the same time treatment of an illness of Shegren does not practice, dryness in a mouth already becomes a constant, and the mucous membrane gains pink color and easily is exposed to injuries. Language also dry, lips can become covered by crusts. Sometimes owing to dryness of a nasopharynx and emergence of crusts in a nose at the patient otitis and temporary deafness develops. Also owing to dryness the voice changes – it becomes osiply. The xeroderma and reduced sweating is characteristic of such patients.
As the general symptoms of an illness the slight anemia increased by SOE is observed. Also the syndrome can be shown in the erased form when the person is disturbed only by dryness of mucous membranes, minor changes of a conjunctiva and increase in sialadens. Also very severe forms of a disease are possible.
If treatment and prevention of an illness are not carried out, then it is fraught with complications. Secondary infectious processes join Shegren's illness. At part of patients the adenosis of external genitals is also observed owing to what women are disturbed by a constant itch, pain and dryness in a vagina.
It is possible to establish the diagnosis at suspicion on Shegren's syndrome in the presence of the corresponding signs. The combination of defeat of sialadens and eyes, existence of dryness in a mouth at various autoimmune diseases demonstrates development of a syndrome of Shegren.
It is necessary to begin treatment of a syndrome of Shegren with therapy of an autoimmune disease which is followed by this sign. In the course of therapy the doctor appoints drugs which podavlyayushche influence autoimmune processes in an organism. Besides, the medicines recovering the struck glands are appointed. Such therapy continues for several years. Besides, the patient appoints vasodilating drugs, fortifying means, vitamins of group B. Use of methods of physical therapy practices. Sedatives are appointed also sick. In process treatment is important to follow rules of hygiene of a mouth.
To prevent a xerophthalmus, to the patient appoint regular use of artificial tears, and in a nose physical solution is dug in. At dryness of a vagina special means for its moistening are used.
Reception of expectorants allows to prevent manifestation of dryness of bronchial tubes. At problems from a digestive tract reasonablly replaceable treatment by enzymes.
It is important to remember that the exacerbation of an illness can provoke a stress therefore it is important to provide stability of a psychological state. By means of special devices it is worth maintaining normal air humidity indoors. At the timely beginning of therapy at a stage of a syndrome of Shegren without accession of an infection the illness in most cases manages to be suspended.
Section: Diseases of eyes