Posted by: Chris Maloney | September 1, 2011

Venus Williams Quits Because of Sjogrens Syndrome: More Than Dry Eyes.

Venus Williams during the 2009 Wimbledon Champ...

Image via Wikipedia

The New York Times reported that Venus Williams has bowed out as a player because of Sjogrens Syndrome.

My first thought was, huh?  She has dry eyes and can’t make saliva, but does that really bother her game?  Sjogrens Syndrome is typically thought of as an inability to produce saliva or to create sufficient tears.  But the same autoimmune response can also affect many other areas of the body.

In Venus Williams’ case, the antibodies can literally slow her down.  Patients with Sjogrens can have slowed psychomotor processing in addition to fatigue, depression, and dry eyes and mouth.

The treatment for Sjogrens is in the preliminary stages.  Treatment with a drug that opposes the antibodies, rituximab, may be helpful, especially combined with steroids in the short term.  But there are no long term studies, and many patients don’t respond.

A recent analysis of Chinese medicine found that combining it and western treatment was more effective than western treatment alone.  In particular, acupuncture is helpful with creating more tears.

We can hope that treatment is successful for Ms. Williams and the her celebrity status brings greater attention to this troubling disease.

Acta Neurol Scand. 2011 Jun 9. doi:
10.1111/j.1600-0404.2011.01530.x. [Epub ahead of print]

Primary Sjogren’s syndrome: cognitive symptoms, mood, and
cognitive performance.

Segal BM, Pogatchnik B, Holker E, Liu H, Sloan J, Rhodus N,
Moser KL.

Source

Department of Medicine, University of Minnesota,
Minneapolis, MN, USA University of Minnesota Medical School, Minneapolis, MN,
USA Department of Physical Medicine and Rehabilitation, University of
Minnesota, Minneapolis, MN, USA Department of Health Sciences Research, Mayo
Clinic, Rochester, MN, USA Department of Oral Surgery, University of Minnesota
School of Dentistry, Minneapolis, MN, USA Arthritis & Immunology Program,
Oklahoma Medical Research Foundation, Oklahoma City, OK, USA.

Abstract

Segal BM, Pogatchnik B, Holker E, Liu H, Sloan J, Rhodus N,
Moser KL. Primary Sjogren’s syndrome: cognitive symptoms, mood, and cognitive
performance. Acta Neurol Scand: DOI: 10.1111/j.1600-0404.2011.01530.x. © 2011
John Wiley & Sons A/S. Objective -  To investigate the relationships between self-reported
cognitive abilities, psychological symptoms and neuropsychological outcomes in
PSS. Methods -  Patients with Primary Sjogren’s syndrome (PSS) and healthy
controls completed a comprehensive neuropsychometric battery and
questionnaires: the Centers for Epidemiological Scale-Depression, the Profile
of Fatigue-mental domain (Prof-M) for cognitive symptoms, Fatigue Severity
Scale, and the Short-Form McGill Pain Questionnaire. Results -  Female patients
with PSS (N = 39) were similar to controls (N = 17) in estimated premorbid
intellectual function, age and education. Depression (P = 0.002), cognitive
symptoms (P = 0.001), fatigue (P = 0.000003), and pain (P = 0.024) scores were
greater in the patient group. Patients with PSS demonstrated inferior
performance relative to controls in psychomotor processing (P = 0.027) and
verbal reasoning (P = 0.007). Patients with PSS with and without depression had
similar performance on multiple tests, but depressed patients had significantly
lower scores for executive function (P = 0.041). Cognitive symptoms correlated
with verbal memory (P = 0.048), whereas pain correlated with executive function
measures (Stroop, P = 0.017) and working memory (Trails B, P = 0.036). In the
regression model, depression and verbal memory were independent predictors that
accounted for 61% of the variance in cognitive symptoms. Conclusion -  The
Prof-M is a simple self-report measure which could be useful in screening PSS
subjects who may benefit from detailed psychometric evaluation. Our results are
consistent with the hypothesis that depression and verbal memory impairment are
overlapping but independent aspects of neural involvement in PSS. While pain
and depression are significant confounders of cognitive function in PSS, this
study suggests that impaired verbal reasoning ability in PSS is not
attributable to pain or depression.

© 2011 John Wiley & Sons A/S.

PMID: 21651503

Expert Opin Biol Ther. 2011 Oct;11(10):1381-94. Epub 2011
Aug 7.

 

Treatment of primary Sjögren’s syndrome with anti-CD20
therapy (rituximab). A feasible approach or just a starting point?

Zhong Xi Yi Jie He Xue Bao. 2011 Mar;9(3):257-74.

[Systematic review and meta-analysis of randomized
controlled trials of Chinese herbal medicine in the treatment of Sjogren’s
syndrome].

 

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