
Juvenile Sjøgren's syndrome in 10 year old child with swollen salivary glands (ultrasound images) and typical tissue sample. Iro H. GMS Curr Top Otorhinolaryngol Head Neck Surg (2014). CC BY NC ND 3.0
Contents
Definition
Primarily Juvenile Sjøgrens Syndrome
Sjøgren's syndrome is rare among children (Juvenile Sjøgren's syndrome). The disease is characterized by a rheumatic inflammation of saliva and lacrimal glands. Other glands and organs can also be affected.
- Primarily Sjøgren's syndrome is a separate one Rheumatic connective tissue disease
- secondary Sjøgren's syndrome occurs as a result of others Autoimmune diseases like systemic lupus (SLE), Juvenile arthritis, rheumatoid arthritis (RA), Systemic sclerosis or Primary biliary cirrhosis (Liver disease). The further information applies in particular primarily Sjögren's syndrome.
Occurrence
Most girls (girl: boy 7: 1) get Sjøgren's syndrome in childhood. The average age at onset in children is 10 years, but the disease can start at any age. In adults, it is most common among women in their 40s.
Symptoms
Some symptoms are as in disease start in adulthood:
- Dryness, redness and irritation of the eyes (keratoconjunctivitis sicca)
- Uncomfortable to look at light (photosensitivity)
- Enlarged salivary glands (applies to parotid and submandibularis glands)
- Dry mouth causes discomfort during chewing and swallowing
- Increased dental problems (carious)
- Hoarseness
- Arthralgia and / or muscle pain
- Raynaud's phenomenon
- Petechial rash (Red dots, mostly on calves)
- Fatigue and increased need for sleep
Blood tests with high ANA, SSA (Sjøgrens Syndrome A) and SSB (Sjøgrens Syndrome B) Antibodies, High immunoglobulin IgG and sedimentation rate (ESR) (low CRP).
Difference from debut in adulthood
One sees greater variation in symptoms in children than among adults with Sjøgren's syndrome
- Fewer symptoms of dryness in the mouth and eyes
- Several have swollen salivary glands (especially parotid gland)
Differential diagnosis
- Drugs that causes dryness
- Relapsing juvenile parotitis
- Other reasons for salivary gland swelling
- Candida infection in the mouth
- Gingivitis or periodontitis (gingivitis)
- Bacterial (retrograde) sialoadenitis (salivary gland inflammation)
- anorexia, bulimia (causing swollen glands)
- Mumps
- Sarcoidosis
- SLE
- Hepatitis C
- Mononucleosis (Epstein-Barr virus infection)
- HIV
- Lymphoma
- Fabry's disease
Medical examinations
General practitioner, rheumatologist and / or pediatrician, ophthalmologist, dentist
The treatment
- As with the onset of disease in adulthood
- Eye drops with "artificial tear fluid" (for example, Viscotears eye gel)
- Good mouth hygiene
- Special medications in some cases (after thorough individual assessment)
Prognosis
Survival is hardly affected if there is no manifestations of internal organs (lung, heart, kidneys). However, there is an increased occurrence of non-Hodgkin's lymphoma (risk factors are persistently low lymphocytes (one type of leukocyte) in blood and low complement factors C3 and C4, (reference: Jonsson MW, 2012).
Literature
More generally about Sjögren's syndrome (among adults) here
Children with rheumatic disease, BINDEVEVSSYKDOMMER.no