Sjogren Symptoms but nothing is detected investigation - #10777
49 years old female Dry eyes, dry mouth bluish tongue, body ache and weakness Suffering started since past 2 years Having medicine almost 5 months but no relief Have done all blood work Schimer testing urine tests chest xray etc as per Rheumatologist suggestion Mouth biopsy too Kindly guide
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Make sure these were checked: ANA (antinuclear antibody) Anti-Ro/SSA, Anti-La/SSB antibodies RF (Rheumatoid Factor) ESR, CRP (inflammation markers) Lip/Mouth biopsy results, confirm lymphocytic infiltration? Thyroid function tests , Hypothyroidism can mimic some symptoms
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Hello dear Please be aware See sjogren syndrome is associated with dry eyes and dry mouth characterized by xerostomia It has typically leafless pattern on sialogeam I suggest you to get sialogram repeat along with indirect inflorescence Then kindly share the lab reports with nearby oral pathologist or oral surgeonfor further treatment Regards
Share biopsy report and antibody results here – crucial for clarity.
If diagnosis is confirmed Sjögren’s, and there’s no response to symptomatic meds, discuss adding HCQ or low-dose steroids with your rheumatologist.
For ongoing fatigue/pain, rule out fibromyalgia and nutritional deficiencies.
Get a repeat CBC, B12, Iron studies, TSH if not already done.
Symptomatic Relief Artificial tears & ocular lubricants
Pilocarpine or Cevimeline (to stimulate saliva)
Sugar-free lozenges, saliva substitutes
Avoid caffeine, smoking, and alcohol
Autoimmune Control (if positive antibodies/biopsy) Hydroxychloroquine (HCQ)
Your symptoms—dry eyes, dry mouth, bluish tongue, body aches, and long-term weakness—along with no relief from current treatment, could suggest an autoimmune condition like Sjögren’s syndrome, even if tests were inconclusive. Sometimes, these conditions take time to clearly show in lab results. Since you’re under a rheumatologist’s care and not improving, it’s best to get a second opinion from another rheumatologist or an autoimmune specialist for re-evaluation and possibly adjusting the treatment plan.
Given the challenges you’re experiencing with persistent symptoms that align with Sjogren’s Syndrome but without a definitive diagnosis, it’s crucial to consider both the common and less common factors. Since typical tests like Schirmer’s, blood work for antibodies (SSA/SSB), and even a mouth biopsy haven’t provided clarity, it might be worthwhile to re-evaluate the interpretation of your test results or explore other potential conditions that can mimic these symptoms. Sometimes, early stages or subsets of Sjogren’s might present atypically or might not yet show detectable markers. While Sjogren’s is primarily known for causing dry eyes and mouth, it’s also worth considering other conditions such as fibromyalgia, chronic fatigue syndrome, or even certain vitamin deficiencies like vitamin D or B12 which can sometimes cause overlapping symptoms like body aches and weakness. It may also be valuable to evaluate lifestyle factors that could be contributing, such as stress levels, hydration status, and any medications or supplements you might be taking that could exacerbate dry symptoms. In the meantime, managing symptoms is important: using artificial tears for eyes, saliva substitutes for dry mouth, and possibly working with a nutritionist to ensure a diet that supports overall health. Regular follow-ups with your healthcare provider or seeking a second opinion from a specialist may also lead to new insights. Additionally, keeping a detailed symptom diary can be very helpful for both you and your doctors, documenting any changes or patterns that might otherwise be overlooked in shorter visits.
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