Sjögren’s disease is a chronic rheumatic condition, autoimmune in nature, which mainly affects women of menopausal age, causing dryness in the skin, eyes, mouth, airways and genital region.
Difficult diagnosis
Depending on the severity and delay in diagnostic recognition, the disease can cause eye damage, tooth loss, social, sexual and quality of life impairments. Additionally, Sjögren’s disease can affect vital organs and be linked to an increased risk of developing lymphoma.
It is estimated that there are around half a million people with the disease in the country and many others still undiagnosed. As they present symptoms that are confused with those of various medical conditions, it is likely that some patients are being monitored by other specialties without due recognition of the disease. This is a reason for better clarification and the great importance of multidisciplinary and multidisciplinary work.
No Hospital das Clínicas Faculty of Medicine of Ribeirão Preto (HCFMRP-USP) there are approximately 300 patients with Sjögren’s disease in regular care, in rheumatology and ophthalmology outpatient clinics, and undergraduate and postgraduate students researching the subject. The Hospital is also one of the centers participating in REBRASS, the Brazilian Registry of Sjögren’s Syndrome, responsible for reporting new cases.
Symptoms
On average, Sjögren’s disease takes between five and six years to be recognized. The most common symptoms are fatigue, body pain and dryness in the eyes (causing redness, a feeling of grit in the eyes and damage to the cornea) and in the mouth (resulting in cavities, tooth loss, difficulty swallowing and speaking). “At other times, dryness symptoms are obscured by more serious manifestations, such as fever, lymph node enlargement, arthritis, skin lesions, neurological disorders and disorders of internal organs, such as the lungs and kidneys. Interestingly, in these more serious cases the diagnosis is postponed and treatment is made difficult”, says the rheumatologist at HCFMRP-USP, Fabíola Reis Oliveira, one of the authors of the book “Sjogren’s Disease – Multidisciplinary approach to clinical practice”.
Book
Launched by publisher Manole in December 2023, “the book is a compendium with the most relevant information about Sjögren’s disease, useful for specialists and other professionals who deal with these patients”. This is the first complete material on the topic produced in Portuguese. “There are chapters dedicated to best diagnostic practices, details on complementary exams and treatment. There are also chapters dedicated to each of the affected organs and systems, including obstetric, fetal, gynecological, endocrine events, among others”, explains Fabíola. “Several specialists from different areas of our hospital and from all over Brazil were invited to make their contribution”, she adds. The authors are: Sandra Gofinet Pasoto, Virginia F. Moça Trevisani, Valéria Valim and Fabíola Reis de Oliveira.
“Science is working towards a better understanding of this disease with a view to developing more efficient and beneficial treatments for these patients. If we can make an earlier diagnosis and be assertive in the treatment, the inflammatory process can be controlled and regressed with minimal consequences. However, interventions carried out at a late stage, when there is already tissue damage and loss of functional capacity of that organ, will only be possible to delay the progression of the disease and alleviate symptoms. This is the power of health education and one of our biggest goals with the book.”
The outpatient clinics at Hospital das Clínicas respond to suspected cases sent by basic health units regulated by CROSS, a system that refers patients to the hospital, and to requests for interconsultation from various related specialties and also dentistry.
