What is dry syndrome?

  Dry syndrome (Sjögren’s Syndrome, SS) is a chronic inflammatory autoimmune disease that mainly involves the exocrine glands. The primary form is SS alone, while the secondary form is combined with other diseases, most commonly connective tissue diseases such as rheumatoid arthritis, systemic lupus erythematosus, and scleroderma.  SS is mostly seen in middle age, but it can occur at any age, more in women than in men. The onset of the disease is insidious, and the clinical manifestations are diverse, with a wide range of severity, mainly exocrine glandular lesions and extraglandular manifestations. Exocrine gland lesions are divided into superficial exocrine glands and visceral exocrine glands. Superficial exocrine gland lesions are the most common, typically dry mouth, waking up at night to drink water, needing water to accompany solid food, dry eyes, reduced tearing, dry eyes, photophobia, foreign body sensation, unable to tolerate contact lenses, and dry skin, reduced leucorrhoea and difficulty in sexual life in female patients, etc. Visceral exocrine gland lesions are less common and mainly include Interstitial pneumonia (one of the main causes of death in SS patients); stomach discomfort and fullness; hepatomegaly, abnormal liver function and even cholestatic hepatitis and cirrhosis; pancreatic involvement with abdominal pain and small intestine absorption dysfunction; renal tubular acidosis with weakness and muscle weakness due to hypokalemia, urinary tract stones and osteoporosis. The most common extra-glandular manifestation is vasculitis, which manifests as skin purpura, Raynaud’s phenomenon, urticaria, joint and muscle pain, anemia, thrombocytopenia and leukopenia, and peripheral neuritis. Very few patients develop B-cell lymphoma (multiple myeloma).  SS is a chronic disease and cannot be “cured”, but most of the patients will not endanger their lives, so there is no need to panic, but need to treat it correctly and reasonably. Patients with dry syndrome should pay attention in daily life and treatment: 1. Dry mouth: avoid spicy and stimulating food, quit smoking, drink more water, rinse mouth or chew gum after meals. 2.  2.Ocular dryness: insist on using artificial tear drops to prevent the progress of corneal lesions.  3.Dry skin: insist on topical moisturizer for the whole body after bathing.  4.Vaginal dryness: use vaginal lubricant before sex.  5.Medication: total peony glucoside, hydroxychloroquine, etc. are the basic medications for SS and need to be taken for a long time; whether or not to use glucocorticoid needs to be based on the condition, in principle, it is used when there are extra-glandular manifestations, significant abnormalities in immunological examination and severe dryness symptoms; other immunosuppressants are also needed when the extra-glandular manifestations are severe; when there is renal tubular acidosis combined with low blood potassium, oral ” Citric acid oral solution”, do not use “potassium chloride”.  6. Regular outpatient follow-up and systematic evaluation if necessary.