Abstract
Sjögren’s syndrome (SS) is a common chronic autoimmune disorder affecting primarily females in the fourth and fifth decade of their life. The autoimmune hallmarks of the disease are attested by the focal lymphoid cell infiltration (Fig. 1) of the exocrine glands and various autoantibodies [28]. The clinical spectrum of the syndrome extends from an organ-specific autoimmune disorder to a systemic process. In addition, features of SS are frequently encountered (5–20%) in patients with almost all autoimmune rheumatic disorders. Patients with SS are also known to have an increased risk for developing B cell lymphoproliferative disorders. The correct diagnosis requires evaluation by various specialists [35]. Differential diagnosis includes adverse effects of drugs, chronic viral infection, e.g., hepatitis C virus (HCV) and HIV, sarcoidosis, lipoproteinemias, amyloidosis, lymphomas and age-related glandular degeneration [12].
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Referenes
Atkinson JC, Fox PC (1993) Sjögren’s syndrome: oral and dental considerations. J Am Dent Assoc 124: 74
Boumpas D, Austin HA III, Vaughan EM, Klippel JH, Steinberg AD, Yaboro CH, Balow JE (1992) Controlled trial pulse methylprednisolone versus two regimens of pulse cyclophosphamide in severe lupus nephritis. Lancet 340: 741
Constantopoulos SH, Tsianos EV, Moutsopoulos HM (1992) Pulmonary and gastrointestinal manifestations of Sjögren’s syndrome. Rheum Dis Clin North Am 18: 617
Daniels T (1994) New approaches to treating dry mouth. In: Homma M, Sugai M, Toyo S, Miyasaka T, Akiyzuki N (eds) Sjögren’s syndrome — State of the art. Kugler, Tokyo, pp 61–65
Fox RI (1992) Treatment of the patient with Sjögren’s syndrome. Rheum Dis Clin North Am 18: 699
Gilbard JP, Rossi SR, Heyda KG, Dartt DA (1991) Stimulation of tear secretion and treatment of dry-eye disease with 3-isobutyl-I-methylxanthine. Arch Ophthalmol 109: 672
Gunduz K, Ozdemir O (1994) Topical cyclosporin treatment of keratoconjunctivitis sicca in secondary Sjögren’s syndrome. Acta Ophthalmol (Copenh) 72: 438
Haddad J, Deny P, Munz-Gotheil C, Ambrosini JC, Trinchet JC, Pateron D, Mal F, Callard P, Beau-grand M (1992) Lymphocytic sialadenitis of Sjögren’s syndrome associated with chronic hepatitis C virus liver disease.Lancet 339: 321
Kassan SS, Thomas TL, Moutsopoulos HM, Hoover R, Kimberly RP, Budman DR, Costa J, Decker JL, Chused TM (1978) Increased risk of lymphoma in sicca syndrome. Ann Intern Med 89: 888
La Corte R, Potena A, Bajocchi G, Fabbri L, Trotta F (1991) Increased bronchial responsiveness in primary Sjögren’s syndrome. A sign of tracheobronchial involvement. Clin Exp Rheumatol 9: 125
Linardaki G, Moutsopoulos HM (1997) The uncertain role of immunosuppressive agents in Sjögren’s syndrome. Cleve Clin J Med 64: 523
Manoussakis MN, Moutsopoulos HM (2000) Sjögren’s syndrome: autoimmune epitheliitis. Baillieres Clin Rheumatol 14: 73
Moutsopoulos HM (1997) Sjögren’s syndrome therapy: future directions. J Rheumatol 24: 33
Moutsopoulos HM, Balow JE, Lawley TJ, Stahl NI, Antonovych TT, Chused TM (1978) Immune complex glomerulonephritis in sicca syndrome. Am J Med 64: 955
Moutsopoulos HM, Tzioufas AG (1994) Sjögren’s syndrome. In: Klippel JH, Dieppe PA (eds) Rheumatology. Mosby Year Book Europe, St. Louis, 6.27.21–26. 27. 22
Moutsopoulos NM, Routsias JG, Vlachoyiannopoulos PG, Tzioufas AG, Moutsopoulos HM (2000) B-cell epitopes of intracellular antigens: myth and reality. Mol Med 6: 141
Nelson D (1994) What’s new in the treatment of dry eye? In: Homma M, Sugai M, Toyo S, Miyasaka T, Akiyzuki N (eds) Sjögren’s syndrome — State of the art. Kugler, Tokyo, pp 61–65
Nelson JD, Farris RL (1988) Sodium hyaluronate and polyvinyl alcohol artificial tear preparations. A comparison in patients with keratoconjunctivitis sicca. Arch Ophthalmol 106: 484
Nelson JD, Gordon JF (1992) Topical fibronectin, in the treatment of keratoconjunctivitis sicca. Chiron Keratoconjunctivitis Sicca Study Group. Am J Ophthalmol 114: 441
Newbrun E (1992) Preventing dental caries: breaking the chain of transmission. J Am Dent Assoc 123: 55
Newbrun E (1992) Preventing dental caries: current and prospective strategies. J Am Dent Assoc 123: 68
Papiris S, Maniati M, Constantopoulos SH, Roussos CH, Moutsopoulos HM, Skopouli FN (1999) Lung involvement in primary Sjögren’s syndrome is mainly related to a small airway disease. Ann Rheum Dis 58: 61
Pavlidis NA, Drosos AA, Papadimitriou C, Talai N, Moutsopoulos HM (1992) Lymphoma in Sjögren’s syndrome. Med Pediatr Oncol 20: 279
Skopouli FN, Barbatis S, Moutsopoulos HM (1994) Liver involvement in primary Sjögren’s syndrome. Br J Rheumatol 33: 745
Ship JA, Fox PC, Michalek JE, Cummins MJ, Richards AB (1999) Treatment of primary Sjögren’s syndrome with low-dose natural human interferon-alpha administered by the oral mucosal route: a phase II clinical trial. IFN Protocol Study Group. J Interferon Cytokine Res 19: 943
Skopouli FN, Papanikolaou S, Malamou-Mitsi V, Papanikolaou N, Moutsopoulos HM (1994) Obstetric and gynaecological profile in patients with primary Sjögren’s syndrome. Ann Rheum Dis 53: 569
Skopouli FN, Talai A, Galanopoulou V, Tsampoulas, Drosos AA, Moutsopoulos HM (1990) Raynaud’s phenomenon in primary Sjögren’s syndrome. J Rheumatol 17: 618
Talai N, Moutsopoulos HM, Kassan SS (1987) Sjögren’s syndrome. Clinical and immunological aspects. Springer, Berlin
Talai N, Sokoloff L, Barth WF (1967) Extrasalivary lymphoid abnormalities in Sjögren’s syndrome (reticulum cell sarcoma, “pseudolymphoma,” macroglobulinemia). Am J Med 43: 50
Tauber J, Crosser VA, Mardelli PG (1993) Improvement of squamous metaplasia following Aquasite TM treatment in patients with dry eye syndrome and in normal volunteers. Invest Ophthalmol Vis Sci 34: 1742
Tsianos EV, Moutsopoulos HM (1989) Sjögren’s syndrome and the gut. Baillieres Clin Rheumatol 3: 357
Van der Reijden WA, Vissink A, Veerman EC, Amerongen AV (1999) Treatment of oral dryness related complaints (xerostomia) in Sjögren’s syndrome. Ann Rheum Dis 58: 465
Vitali C, Bombardieri S, Moutsopoulos HM, Balestrieri G, Bencivelli W, Bernstein RM, Bjerrum KB, Braga S, Coll J, Vita S de (1993) Preliminary criteria for the classification of Sjögren’s syndrome. Results of a prospective concerted action supported by the European Community. Arthritis Rheum 36: 340
Vivino FB, Al-Hashimi I, Khan Z, LeVeque FG, Salisbury PL III, Tran-Johnson TK, Muscoplat CC, Trivedi M, Goldlust B, Gallagher SC (1999) Pilocarpine tablets for the treatment of dry mouth and dry eye symptoms in patients with Sjögren syndrome: a randomized, placebo-controlled, fixed-dose, multicenter trial. P92–01 Study Group. Arch Intern Med 159: 174
Vlachoyiannopoulos PG, Moutsopoulos HM (1997) Therapy of Sjögren’s syndrome. In: Putte L de, Furst D, Williams J, Riel P van (eds) Therapy of systemic rheumatic disorders. Marcel Dekker, New York, pp 615–628
Weiner H, Friedman A, Miller A (1994) Oral tolerance: immunogenetic mechanisms and treatment of animal and human organ-specific autoimmune disease by oral administration of autoantigens. Annu Rev Immunol 12: 809
Zulman J, Jaffe R, Talal N (1978) Evidence that the malignant lymphoma of Sjögren’s syndrome is a monoclonal B-cell neoplasm. N Engl J Med 299: 1215
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Moutsopoulos, N.M., Moutsopoulos, H.M. (2002). Therapy of Sjögren’s syndrome. In: Harrison, W.B., Dijkmans, B.A.C. (eds) Combination Treatment in Autoimmune Diseases. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-04759-0_10
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DOI: https://doi.org/10.1007/978-3-662-04759-0_10
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