Sjögren Syndrome

Σύνδρομο Sjögren
Sjögren’s Syndrome, or autoimmune epithelitis, as it is known, is a chronic, autoimmune disease that mainly affects the exocrine glands. The main exocrine glands affected are salivary glands and lacrimal glands. This syndrome, with difficult pronunciation, is an autoimmune disease. It derives from an abnormal immune response which is directed against healthy tissues of the body itself.

Sjögren’s Syndrome is divided into primary and secondary. It is characterized as primary when it occurs alone and as secondary when it occurs along with other diseases, such as Systemic Lupus Erythematosus, Rheumatoid Arthritis, Scleroderma, etc.

The disease can affect people of all ages. However, it is more common in middle-aged women, with the female-to-male ratio being 9: 1. It is a fairly common disease, as it is estimated to affect 1% of adult women. In the US, about 4 million people suffer from Sjögren’s Syndrome. In Greece, the first epidemiological study on rheumatic diseases, conducted by the Hellenic Institute of Rheumatology, revealed that the incidence of the disease in the Greek population is 1%.


What are the symptoms of Sjögren’s Syndrome?

The diagnosis of Sjögren’s Syndrome can be difficult to diagnose, as symptoms of the disease may vary from patient to patient, but may even change over time or be associated with non-specific symptoms (e.g. fever, fatigue). Symptoms of Sjögren’s Syndrome include:

  • Dry eyes – Feeling a foreign body in the eyes
  • Dry mouth – Difficulty swallowing
  • Dryness of skin and / or appearance of rashes
  • Change in the sense of taste
  • Ulcers in the mouth or trachea
  • Fatigue
  • Joint pains
  • Vaginal dryness and pain during intercourse
  • Swelling of salivary glands


How to diagnose Sjögren’s Syndrome

Every physician who observes a patient with some of the above symptoms should thoroughly investigate the possibility that this patient has Sjögren’s Syndrome. The two most are dry mouth and dry eyes.

In the case of dry mouth, the doctor in charge is the Otolaryngologist, who will evaluate the dryness of the oral cavity and the possible swelling of the parotid glands or salivary glands. Malignant gland dysfunction can be confirmed by biopsy, which is performed under local anesthesia, and is subsequently assessed microscopically by a diagnostic laboratory.

The Ophthalmologist is the one who will examine the eyes, may detect the dry eyes and through special painless tests (Schirmer test, Rose Bengal dye test) will assess the potential damage from prolonged ocular dryness.

Blood tests can help diagnose the syndrome. Indicators commonly checked are the following:

  • Anti-nuclear antibodies (ANA)
  • Rheumatoid Factor
  • Anti-SSA (Ro) antibodies
  • Anti-SSB antibodies (La)
  • Erythrocyte Sedimentation Rate (ESR)


Classical Therapeutic Treatment

The treatment regimen applied to each patient depends on their symptoms and their severity. In this context, your doctor may recommend:

  • Artificial tears and ocular lubricant ointments
  • Non-steroidal anti-inflammatory drugs
  • Medicines that promote salivary secretion (eg pilocarpine)
  • Glucocorticoids (eg cortisone)
  • Immunomodulators – immunosuppressive drugs (eg azathioprine, methotrexate)
  • Biological agents (eg rituximab)

It is important to note that these therapeutic regimens are intended to alleviate symptoms and do not address the underlying cause of the disease.



The Modern Medical Approach

A key point of a modern Medical Approach is the detection and identification of any dysfunctions, at the Molecular and Cellular level. This is achieved through Hematological/ Hormonological tests as well as innovative specialized diagnostic tests, which reveal any deviations from normal to the cell metabolism. At the same time, all those deficiencies of Micro- and Macronutrients that have contributed to the development of the disease are identified.

After a thorough analysis of the medical history and lab test results and based on medical algorithms, a personalized treatment regimen is determined for each patient.

The patient does not need to change anything in his daily life and gradually observes the overall improvement of his health levels.

The duration of the follow-up depends on the overall clinical condition of the patient and ranges from 6 to 18 months.

This personalized treatment does not contradict another parallel drug and / or homeopathic treatment.




Dr. Nikoleta Koini, M.D.

Doctor of Functional, Preventive, Anti-ageing and Restorative Medicine.

Diplomate and Board Certified in Anti-aging, Preventive, Functional and Regenerative Medicine from A4M (American Academy in Antiaging Medicine).


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