ANALYSIS OF MULTISYSTEMIC MANIFESTATIONS OF SJÖGREN'S SYNDROME: A FOCUS ON DERMATO-OPHTHALMOLOGICAL INTERRELATIONS

Resumo

Sjögren’s Syndrome (SS) is a systemic autoimmune disease known for its hallmark symptoms of dry eye and dry mouth, but it also presents a spectrum of extraglandular manifestations affecting the skin, lungs, nervous system, and other organs. This systematic review examines the multisystemic impacts of SS, highlighting advancements in diagnostics, therapeutic strategies, and clinical challenges. A comprehensive search was conducted across PubMed, MEDLINE, and Embase for studies published between 2013 and 2024, using keywords such as "Sjögren’s Syndrome," "Multisystemic Manifestations," "Autoimmune Disease," and "Extraglandular Complications." Of the 56 initially identified articles, 13 met the inclusion criteria. Findings reveal that pulmonary complications, including interstitial lung disease, occur in 9–20% of SS cases, as reported by Flament et al. (2016), emphasizing the importance of imaging and biopsy for early detection. Dermatological manifestations, such as vacuolar interface dermatitis and vasculitis, were detailed in studies by El Hasbani et al. (2023) and Kakurai et al. (2021), which underscore the need for dermatological vigilance in systemic autoimmune diseases. Neurological symptoms, including peripheral neuropathies and neuropsychiatric complications, were identified as early indicators in studies by Posso-Osorio et al. (2019) and Salehi et al. (2024), suggesting that such presentations require immediate multidisciplinary evaluation. Therapeutic advancements include the use of corticosteroids, hydroxychloroquine, and biologic agents such as rituximab, which have shown efficacy in managing systemic manifestations. Chu et al. (2020) emphasized the benefits of immunosuppressive therapy in improving systemic outcomes while acknowledging the limited efficacy for glandular symptoms. Advanced diagnostic tools like PET/CT, explored by Sharma and Chatterjee (2015), have improved diagnostic precision, aiding in the differentiation of SS from other systemic conditions. Despite these advancements, challenges remain in addressing disease heterogeneity and atypical presentations, particularly in men, children, and patients without classic glandular involvement. Standardized diagnostic protocols and tailored therapeutic strategies are needed to improve outcomes and reduce the burden of extraglandular complications.