Suggest Treatment For Sjögren's Syndrome

Posted on Thu, 26 Feb 2015

Question: Hi there,
I was just diagnosed by endocrinologist as having Sjogren's Syndrome. I have positive ANA and positive SSB (1.0). However, I do not have positive SSA (<0.2). My monocytes (absolute) are also high at 1.0. How can my doctor say this is Sjogren's and "definitely" not SLE? I'm confused because what I have read so far indicates it could be lupus as well. She has referred me to a rheumatologist that I will see in 2 weeks.
Thanks, XXXXXXX B.

Answered by Dr. Naval Mendiratta (44 minutes later)

Brief Answer:
? sjogrens syndrome

Detailed Answer:
Good evening

Thank you for writing on health care magic

Well sjogrens and sle are like close sisters. At times it is hard to distinguish them but it depends mostly on the symptoms. Both are multisystem disease but yes sle is more fatal

If you could describe my the symptoms you have been experiencing it would give me a clear picture. I can ask questions but that would be more of leading ones. So do let me know the symptoms you have been experiencing.

Accordingly I can guide you

Await.your reply

Regards
Dr naval

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Naval Mendiratta (45 hours later)

My symptoms seemed to begin in 2006 after the birth of my second child. Since then i have been diagnosed with the following:
Diffuse alopecia
Low B-12
Low free testosterone
Hypothyroidism
Degenerative disc disease (2 surgeries)
Inflammation of eyes and corneas
Bronchiectasis (showed during scan on lungs when i had a lung infection)
Recently Sjogrens (last week) by my endocrinologist
Low estrogen

Other symptoms include:
Severe leg cramps
Muscle and joint pain
Fatigue
Lack of motivation
Irratibility
Feeling down
Splitting nails
Memory loss or fog
Constipation
Diahrrea
Gastritis
Mid-back pain
Chronic neck and low back pain
"Sinking spell" - heart race and/or beat hard for a short time followed by extreme fatigue ( had this problem for maybe 2-3 years then just went away with no explanations from doctors)

Some symptoms are present most of the time and some come and go (flares)

Hope this helps. Thank you!

Also add dry eyes and mouth to symptoms list

Answered by Dr. Naval Mendiratta (12 hours later)

Brief Answer:
? Is it Sjogrens

Detailed Answer:
Good evening

Thank you for your reply

Well, Sjogrens and SLE are quite a close replicas. Both are equally fatal, except that SLE is more. I have gone through your symptoms list. Dry eyes/Dry mouth along with ANA Positive and SSB positive, do favour Sjogrens. Although Alopecia, fatigue, cramps, memory fog are a very common symptom and can be a part of any connective tissue disease. The definite diagnosis can be done by salivary gland Biopsy if you want.

But the important part you need to understand is the organ involvement in both the diseases. If it is just a minor organ involvement, the treatment remains the same for both the diseases that is hydroxychloroquine and maybe a low dose of steroids.

With SLE the most common organ you need to monitor is your kidneys. But your symptoms fit more with Sjogrens.

Do consult a rheumatologist and let him examine you as well. Examination is any day more conclusive and will give us a more clear idea.

Do let me know for more queries

Regards

Dr naval

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Above answer was peer-reviewed by : Dr. Prasad