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Taipei City Hospital


The Troublesome Sicca Syndrome

Sicca syndrome is also known as Sjögren's syndrome, with the main manifestation being systemic skin drying, which is often regarded as a normal nonspecific symptom and is thus ignored. Xu Jing-hui, attending doctor of the Division of Allergy, Immunology and Rheumatology in Yangming Branch of Taipei City Hospital, says that sicca syndrome is a relatively common autoimmune disease, comprising primary sicca syndrome and secondary sicca syndrome. The prevalence of primary sicca syndrome is about 0.1% to 4.6%. The symptoms of some autoimmune diseases are also manifested via disorder of salivary gland or tear gland and abnormal test results, which are called secondary sicca syndrome. Researches show that about 17% of rheumatoid arthritis patients and 8% to 20% of systemic lupus erythematosus patients are likely to be complicated by sicca syndrome.

The most important clinical manifestations are dry eyes and xerostomia, as well as occasional invasion of other exocrine glands or internal organs. Other symptoms comprise dry skin, itching and reduction of respiratory secretions which many result in nasal dryness and bleeding, hoarse voice and chronic cough. One important thing to note is that it may suggest lymphoma. About 4% to 10% patients with primary sicca syndrome will suffer from lymphoid hyperplasia, over 6 times higher than among normal people, while the incidence of other cancers is not much higher.
Dr. Xu adds that the currently used clinical diagnosis standards were determined by the American-European Consensus Group Meeting in 2002, which comprise over 3 months’ clinical manifestations of xerostomia and dry eyes and relevant examinations. Patients matching certain symptoms are diagnosed with sicca syndrome.

There is general therapy and drug therapy for sicca syndrome. People with xerostomia, for example, can chew sugar-free gum, maintain oral hygiene and visit the dentist regularly. Those with dry eyes shall avoid excessive use of eyes and reduce the time of staying in air-conditioned room or strong wind environment. Regardless of which symptoms, they shall avoid staying up, drinking or smoking.

Dr. Xu further reminds that sicca syndrome is often ignored. People with these clinical symptoms should seek the help of specialist physicians as early as possible, which can not only effectively alleviate discomfort, but also diagnose possible complications earlier.