China ; Humans ; Xerostomia ; classification

Sjogren's syndrome is an autoimmune disease that is characterized by keratoconjunctivitis sicca and xerostomia. Small-fiber neuropathy is rare, although neurological manifestations occur in as many as 30% of patients with Sjogren's syndrome. We report herein a patient with Sjogren's syndrome who presented with autonomic neuropathy and painful sensory neuropathy. Primary Sjogren's syndrome should be considered in the differential diagnosis of small-fiber neuropathy.
Autoimmune Diseases ; Diagnosis, Differential ; Humans ; Keratoconjunctivitis Sicca ; Neurologic Manifestations ; Sjogren's Syndrome ; Xerostomia

Sjogren's syndrome is a chronic,slowly progressive,autoimmune disease in which the exocrine glands are damaged by lymphocytic infiltration,resulting in xerostomia and xerophthalmia.Fever in patients with Sjogren's syndrome is rarely manifested with the exception of cases with complicated illness such as lymphoma.We experienced a 70-year-old male patient with Sjogren's syndrome who was presented with fever of unknown origin.Despite of thorough investigation,other diseases to cause fever could not be found.Fever and other clinical features were improved with empirical steroid therapy.
Aged ; Exocrine Glands ; Fever of Unknown Origin* ; Fever* ; Humans ; Male ; Sjogren's Syndrome ; Xerostomia

OBJECTIVE: To investigate the usefulness of the Hardtack test to screen the Sjogren's syndrome compared with non-stimulated whole salivary flow (NSWSF) and Schirmer-1 test. METHODS: Fifty patients with RA and other connective tissue disease who had complained sicca symptoms (7 males and 43 females) and twenty healthy participant, were undergone the Hardtack test, NSWSF, and Schirmer-1 test. The Hardtrack test were compared with NSWSF and Schirmer-1 test for the screening of Sjogren's syndrome. And the relationship between the tests were evaluated. RESULTS: 1) The time of dissolution of the hardtack was 88.7sec (Max: 136, Min: 44) in healthy group, and 321 sec (Ma: 900, Min: 92) in patient group (p<0.001). 2) NSWSF was 0.6 ml/min (Max: 1.32, Min: 0.14) in healthy group, and 0.28 ml/min (Max: 0.8, Min: 0.01) in patient group (p<0.001). 3) The lacrimal flow in Schirmer-1 test was 22.0 mm (Max: 30, Min: 8) in healthy groups and 5.26 mm (Max: 21, Min: 0) in patient group (p<0.001). 4) The correlation coefficient between the hardtack test and NSWSF was 0.56 (p<0.001). The correlation coefficient between the hardtack test and Schirmer-1 test was 0.51 (p<0.001). NSWSF was correlated with Shirmer-1 test but not significantly (r=0.254, p=0.075). In the hardtack test, the best balance between sensitivity and specificity was seen with a cut-off value of 120 seconds. CONCLUSION: The Hardtack test is useful screening test to discriminate between subjects with normal and reduced salivary flow. The Hardtack test is easy to perform, inexpensive, imposes minimal discomfort on the subject with xerostomia and correlated well with the NSWSF and the Schirmer-1 test. So it can also be used as to monitor the Sjogren's syndrome before the salivary flow measurement or Schirmer-1 test.
Connective Tissue Diseases ; Humans ; Korea* ; Male ; Mass Screening ; Sensitivity and Specificity ; Sjogren's Syndrome* ; Xerostomia

Background: Gougerot-Sj\xf6gren syndrome is an autoimmune disorder with two remarkable symptoms such as dry eyes and dry mouth. Objective: To study the symptoms of dry mouth of Gougerot-Sj\xf6gren syndrome after rheumatoid arthritis; To evaluate clinical and subclinical manifestations of dry mouth. Subjects and method: A prospective, descriptive, cross-sectional study included 160 patients with rheumatoid arthritis, who treated at Department of Rheumatology of Bach Mai hospital, from 1998 to 2003. The patients were divided into 2 groups: 60 patients with Gougerot-Sj\xf6gren syndrome and 100 patients without Gougerot-Sj\xf6gren syndrome. Results: The average age of patients with Gougerot-Sj\xf6gren syndrome was 54.55 \xb1 10.91 years. The mean time of having dry mouth was 8.65 \xb1 8.39 months. Clinical manifestations of dry mouth were sensation of dry mouth (90%), lost of saliva (80%), drink a lot of water while eating (58.3%), enlargement of parotid glands (15%). Degrees of dry mouth were mild and moderate (36.7%), severe (53.3%). 93.3% of patients decreased total salivary flow.82% of patients had 3 and 4 anatomopathologic stages according to Chilsom classification. Conclusion: Incidence of symptoms of dry mouth was higher significantly in the rheumatoid arthritis patients with Gougerot-Sj\xf6gren syndrome than those without Gougerot-Sj\xf6gren syndrome.
Arthritis ; Rheumatoid/ pathology ; diagnosis ; Sjogren's Syndrome/ pathology ; diagnosis ; Xerostomia/ pathology ; diagnosis

xerostomia commonly. They have considerable difficulty in wearing tissue-supported prosthesis and high risk rate of caries. One of them is Sjogren's syndrome patient.Sjogren's syndrome is a chronic inflammatory autoimmune disorder that results in a lymphocyte-mediated destruction of exocrine glands. We planned to place implants immediately after extraction in this case of autoimmune disease. The advantages of immediate implant placement include considerable decrease in time from tooth extraction to placement of the final prosthesis, fewer surgical procedures, and better acceptance of the overall treatment plan. We present a case of Sjogren's syndrome patient treated with immediate implant placement & immediate loading in anterior region and immediate implant placement in posterior region.]]>
Autoimmune Diseases ; Exocrine Glands ; Humans ; Prostheses and Implants ; Sjogren's Syndrome ; Tooth Extraction ; Xerostomia

Sj9gren's syndrome(SS) is an autoimmune disease with glandular dysfunction caused by the massive infiltration of the exocrine glands by lymphocytes. The pathogenesis of this disease is related to the chronic inflammatory response of the exocrine glands due to excessive activation of B cells and T cells. In addition to dry mouth and eyes, SS can also cause damage to other organs and systems in the human body, seriously affecting the quality of life of patients. Traditional Chinese medicine(TCM) has definite clinical efficacy in the treatment of SS as it can alleviate symptoms and regulate immune disorders without causing adverse reactions, demonstrating high safety. This paper reviews the current status of preclinical and clinical trials about the TCM treatment of SS in the past decade. TCM mainly mitigates SS symptoms such as dry mouth, dry eyes, dry skin, and joint pain and improves the prognosis and quality of life of patients by regulating the abnormally activated B cells and T cells, inhibiting the autoimmune response, restoring the balance between pro-inflammatory and anti-inflammatory cytokines, and reducing the pathological damage caused by immune complexes to exocrine glands and joints in SS patients.
Humans ; Sjogren's Syndrome/drug therapy* ; Medicine, Chinese Traditional ; Quality of Life ; Xerostomia ; Autoimmune Diseases

OBJECTIVE: To understand the clinical characteristics about sequence diagnosis and treatment of oral complications in patients with Sjögren's syndrome (SS) through retrospective analysis, and to provide some guidance for clinical work. METHODS: Some SS patients who underwent oral sequence management in the Department of General Dentistry, Peking University School and Hospital of Stomatology from January 2015 to September 2021 were enrolled. For the SS patients included in this study, a comprehensive oral examination was performed, including parotid region examination, oral mucosal exa-mination, dentition examination, dental examination, periodontal examination, unstimulated salivary flow rate, Candida infection and radiological imaging examination. According to the examination results, the patients were given fluoride application, antifungal treatment, root canal therapy, direct filling repair, and indirect repair treatment in sequence and the results recorded. RESULTS: A total of 9 patients with SS, with 4 primary SS patients (pSS) and 5 secondary SS patients (sSS) were enrolled in the study. For all the 9 patients, the average age was (49.2±16.2) years and the median xerostomia duration 5 years. The unstimulated salivary flow rate of the 9 patients was all less than 1 mL/10 min. Eight of the 9 cases was diagnosed as oral Candidiasis, with positive salivary Candida culture result (>200 cfu/mL), and 1 of the 9 cases was not. The average decay, missing, filling teeth (DMFT) was 24.8±4.2; the average decay, missing, filling tooth surfaces (DMFS) was 59.2±21.9, the average incisal caries was 2.5±1.3, and the average number of crown restorations at baseline was 4.5±3.6. All the 9 SS patients were applied with topical fluoride usage, and 8 were prescribed with antifungal treatment. One sSS patient was conducted with filling restoration treatment, one pSS patient was conducted with full mouth rehabilitation, and the remaining 7 patients were conducted with direct filling combined with fixed repair treatment. The average 3.2 full crown restorations in 6 patients had to be removed and restored because of secondary caries, and 3 of the 9 patients underwent implant denture restorations finally. CONCLUSION Management of oral complications in SS patients needs to be carried out in sequence. A comprehensive examination and diagnosis should be carried out first, followed by infection control, and then restoration of oral function at last.
Humans ; Adult ; Middle Aged ; Aged ; Sjogren's Syndrome/complications* ; Retrospective Studies ; Antifungal Agents ; Xerostomia ; Fluorides

PURPOSE: Parotid gland can be considered as a risk organ in whole brain radiotherapy (WBRT). The purpose of this study is to evaluate the parotid gland sparing effect of computed tomography (CT)-based WBRT compared to 2-dimensional plan with conventional field margin. MATERIALS AND METHODS: From January 2008 to April 2011, 53 patients underwent WBRT using CT-based simulation. Bilateral two-field arrangement was used and the prescribed dose was 30 Gy in 10 fractions. We compared the parotid dose between 2 radiotherapy plans using different lower field margins: conventional field to the lower level of the atlas (CF) and modified field fitted to the brain tissue (MF). RESULTS: Averages of mean parotid dose of the 2 protocols with CF and MF were 17.4 Gy and 8.7 Gy, respectively (p < 0.001). Mean parotid dose of both glands > or =20 Gy were observed in 15 (28.3%) for CF and in 0 (0.0%) for MF. The whole brain percentage volumes receiving >98% of prescribed dose were 99.7% for CF and 99.5% for MF. CONCLUSION: Compared to WBRT with CF, CT-based lower field margin modification is a simple and effective technique for sparing the parotid gland, while providing similar dose coverage of the whole brain.
Brain ; Humans ; Parotid Gland ; Xerostomia

Sjogren's syndrome is a systemic disorder and characterized by keratoconjunctivitis sicca, xerostomia, and connective tissuedysfunction(arthritis). A 42 year-old Korean iemalehad progressive loss of visual acuity in both eyes. In addition she has dry eyes, dry mouth and arthritis of 8 years duration. Clinical findings include cornea punctate, filamentary karatitis and decreased lacrimal secretions of both eyes. A diagnosis of Sjogren's syndrome was made. The karatoconjunctivitis siccawas treated with artificial tear and soft contact lens.
Adult ; Arthritis ; Contact Lenses, Hydrophilic ; Cornea ; Diagnosis ; Humans ; Keratoconjunctivitis Sicca ; Mouth ; Sjogren's Syndrome* ; Tears ; Visual Acuity ; Xerostomia