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Q: I have a 56-year-old neighbor who has been to doctor after doctor for two or three years, and they still can't diagnose what's wrong with her.

Her mouth is sore and she has a hard time swallowing food and getting it to go down. Her teeth have begun breaking off as well. She is in pain all the time, and she can hardly get out of bed in the morning. About nine months to a year ago, varicose-like veins started popping up all over her legs. She complains about her chest hurting so bad. Her most recent symptoms are dryness of the mouth and eyes. Her muscles seem to be disintegrating as well.

Tonight I saw on the news a "mystery illness" and it turned out to be Sjogren's Syndrome, which appears to have a lot of the symptoms that my neighbor has. Any information you can give me will be greatly appreciated.

-- D.W.
A: It certainly sounds like your neighbor may have Sjogren's Syndrome and perhaps some associated problems. Let me explain.

Sjogren's Syndrome is a chronic autoimmune disorder. "Autoimmune" means the immune system is inappropriately attacking some of the normal cells in the body.

Ninety percent of those with Sjogren's are women. It usually begins to show up between 40 and 60 years of age.

The more common symptoms of Sjogren's include excessive dryness of eyes, mouth and other areas of the body covered by mucous membranes. Fibromyalgia, chronic fatigue and some mental problems are also seen.

Lack of tears can result in damage to the eye; dryness of the mouth can lead to loss of taste and smell, difficulty in speaking and eating, and severe dental problems.

In many people, other tissues and organs can be affected as a result of increased susceptibility to infection and inflammation caused by immune system dysfunction. Pneumonia, pericarditis (infection of the heart's covering) and nerve damage can occur.

In addition, Sjogren's is "associated" with a number of other diseases, including rheumatoid arthritis (the most common), lupus, scleroderma, cirrhosis and thyroiditis. The association with these other diseases doesn't mean that Sjogren's causes them, but rather, they are all caused by other unknown, and perhaps similar, factors.

Kidney problems occur in over 20 percent of people with Sjogren's. Non-Hodgkin's lymphoma is 44 times more common in people with Sjogren's than in the general population.

Your neighbor may have some of the symptoms of these diseases. If she has not already done so, she should be checked out for these problems.

Treatment is two-pronged. First, as I've noted, the associated disorder(s) must be identified and treated aggressively. Next comes treatment of the symptoms of Sjogren's with accompanying supportive care.

For example, artificial teardrops can be used to keep dry eyes moist, and dry mouth can be alleviated by frequent sipping of liquids or chewing sugarless gum. Drugs that dry up mucous membranes, such as antihistamines, should be avoided.

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