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September 2, 2011 07:48  by Dr. Marla Shapiro

Venus William's announcement highlights a disease that is often misunderstood and under diagnosed.

Sjogren Syndrome is a chronic disease. We consider this an inflammatory disorder that can affect many different organs. The typical symptoms are called "sicca symptoms," which refers to the dryness that patients can experience. This includes dry eyes, dry mouth and involvement of one of our salivary glands called the parotid gland.

There can be other symptoms unrelated to glands, such as arthritis and muscle aches, lung involvement, gastrointestinal disease and anemia as well as involvement of nerves and kidneys, to name a few. In primary Sjogren, the syndrome is unrelated to other underlying rheumatic diseases, whereas the secondary kind is associated with another underlying disease such as lupus or rheumatoid arthritis.
 
Sjogren is seen throughout the world and can affect persons of all races. It is interesting, however, that the ratio of females to males afflicted with the disorder is 9 to 1. While it can affect people of all ages, it typically is seen in older individuals and typically the onset is after age 40. Newer data and greater awareness has the disease now being diagnosed among younger women as well. However, the mean time between onset of symptoms and diagnosis is usually six years. The Arthritis Society here in Canada believes that it is seen in 1% of our population.
 
It is thought that genetics, hormones and environmental factors such as a viral infection might play a role. It is an autoimmune disorder when our immune system makes cells called lymphocytes that attack the moisture producing glands of the body and other tissues. Symptoms include:

  • dry mouth and eyes
  • difficulty chewing and swallowing
  • swollen salivary glands
  • fatigue
  • joint pain
  • numbness

The diagnosis is based on the presence of certain criteria. We can measure how dry the eyes are as well (Schirmer test), as finding abnormal antibodies in the blood work. Sometimes we will do a tissue biopsy behind the lip.
 
While there is no cure at present for this disorder, treatment is designed to control the symptoms and prevent damage to the teeth and surface of the eyes. Medication can be given to stimulate saliva production and drops can be used to moisturize the eyes. In addition, there are medications that are used to slow down the inflammation.
 
It is important that patients do take care of their skin, oral health and eyes and avoid medications such as antihistamines and others that can promote dryness. Exercise is important to keep up the range of motion and prevent stiffness.
 
This disorder is more common than previously thought and some experts consider this to be the second most common autoimmune rheumatic disease after rheumatoid arthritis. The big questions is what does this mean to Venus long term? The answer is unknown as we cannot predict the course it will follow. Hopefully, her symptoms can be managed and she will be back at the sport she loves!

WATCH: My segment on Canada AM: Sjogren Syndrome

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Dr. Marla Shapiroclose [x]

Dr. Marla Shapiro, MDCM CCFP MHSc FRCP(C) FCFP, is a family physician and the Health and Medical Contributor for CTV's Canada AM as well as the editor of Parents Canada magazine, launched in March 2007.

She completed medical school at McGill University and trained at the University of Toronto for her Masters of Health Science in Community Health and Epidemiology. She holds a Fellowship in Family Medicine and is a NAMS credentialed menopause specialist. She is an associate professor in the Department of Family and Community Medicine at the University of Toronto, where she recently won an award for Creative Professional Activity.

Dr. Shapiro won the Society of Obstetricians and Gynaecologists of Canada/Canadian Foundation for Women's Health Award for Excellence in Women's Health Journalism in 2006 for her documentary "Run Your Own Race." Her book, "Life in the Balance: My Journey with Breast Cancer" was released in the fall of 2006 and is a national bestseller.

For her lifelong commitment to family medicine, Shapiro was awarded the College of Family Physicians of Canada's Award of Excellence for 2008.

Angela Mulhollandclose [x]

Angela Mulholland is the editor of CTV News' semi-weekly health newsletter MedNews Express as well as the MedNews Express Blog.

She has been a journalist for CTV News since 2000, covering current affairs, health and entertainment for CTV.ca. Before CTV, she worked for CBC.ca for two years.

She has a degree from St. Jerome's University in Waterloo, ON, and studied journalism at Sheridan College in Oakville. She lives in Toronto with her husband and two children.

Monica Matysclose [x]

Monica Matys has been the health and wellness reporter for CTV News Toronto since 2001. Her feature health report, Lifetime, can be seen on CTV Toronto's News at Noon and at 6 p.m.

Her interest in the medical field began while working for a medical publishing company as the editor of a monthly magazine. One of Monica's favourite days on the job was the time she got to spend a day in Credit Valley Hospital's Emergency unit. "It really opened my eyes to the strains on our system," Monica explains.

Matys grew up in Scarborough, and has an honours degree in Journalism from Carleton University in Ottawa. She lives in Toronto with her husband and two children.

Avis Favaroclose [x]

Avis Favaro has been with CTV News since 1992, producing stories for CTV National and CTV News Channel - Newsnet- as well as for CTV affiliate stations across the country.

Avis and producer Elizabeth St. Philip won the 2008 Media Awards for Excellence in Health Reporting handed out by the Canadian Nurses Association and the Canadian Medical association for a story on BPA found in food cans.

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Dr. Yoni Freedhoffclose [x]

Dr. Yoni Freedhoff, MD CCFP Dip ABBM, is the founder and Medical Director of the Bariatric Medical Institute in Ottawa, a multi-disciplinary behavioural weight management program. Formally trained in family medicine, since 2004 his practice has been exclusively dedicated to the treatment of overweight and obesity.

Dr. Freedhoff has been referred to as a "nutritional watchdog" by the Canadian Medical Association Journal and a national "obesity expert" by the Canadian Obesity Network. His advocacy efforts for improved public policies regarding nutrition and obesity have found him testifying in front of the Canadian House of Commons, giving press conferences with the Ontario Medical Association, commenting regularly in the national media, and as a sought after lecturer.

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Dr. Grant Lumclose [x]

Dr. Lum is a sports medicine physician. He is the medical director and founder of Athletic Edge Sports Medicine, a multidisciplinary sports medicine organization offering services to the athletic and active public.

He is involved in the care of recreational, elite amateur and professional athletes, including players in the NHL, NFL and NBA. He is also involved in the performing arts medical community, taking care of musicians, vocalists, dancers and other performing artists.

Dr. Lum studied medicine at the University of Toronto, where he graduated in 1992. He completed a two-year residency in Family Medicine, and then specialty training in Sports Medicine.

He is a lecturer at the University of Toronto's Faculty of Medicine, an adjunct professor at York University's Faculty of Fine Arts, and medical director of George Brown College's Fitness and Lifestyle Management Program.

Dr. Lorne Brandesclose [x]

A senior oncologist at CancerCare Manitoba, Dr. Brandes received his MD from the University of Western Ontario in 1968.

Following post-graduate training at the Royal Marsden Hospital (London) and the University of Manitoba, he joined the faculty at U. Of M. in 1975, where he is a professor in the Departments of Medicine and Pharmacology.

He is also affiliated with the Manitoba Institute of Cell Biology.

Dr. Katy Kamkar, Ph.D., C. Psych.close [x]

Dr. Katy Kamkar, Ph.D., C. Psych., is a Clinical Psychologist at the Work, Stress and Health Program/Psychological Trauma Program, at the Centre for Addiction and Mental Health (CAMH). She also provides private practice at the CBT Associates of Toronto and is a lecturer in the Department of Psychiatry, University of Toronto.

She completed her Honours Degree in Psychology and Mathematics at York University and her Masters and Ph.D. in Clinical Psychology at Concordia University. She also completed a Clinical/Research Postdoctoral Fellowship at CAMH. She has received numerous academic awards and distinctions.

Kamkar provides consultation, comprehensive assessments, and evidence-based Cognitive-Behavioural treatment for Mood and Anxiety Disorders, including psychological distress related to stress and anxiety in the workplace. She also provides training, education, and supervision as well as various educational seminars and workshops. She adheres to a scientist-practitioner model of practice and integrates research and science with practice.

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Dr. Neil Rauclose [x]

Dr. Neil Rau grew up in Ottawa. He initially studied mathematics at the University of Waterloo before completing his MD at the University of Toronto in 1991. He completed training in Internal Medicine and Infectious Diseases at McGill University in 1996, before establishing a busy private practice in Oakville. He is currently the medical director of Infection Prevention and Control at Halton Healthcare Services.

In 2008, he completed his training in medical microbiology at the University of Toronto and he now serves as the medical microbiologist and chair of the patient safety steering committee at his hospital.

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Registered dietitian Cara Rosenbloom believes that nutrition can make a difference in overall health and wellness and enjoys translating complex nutrition information into usable and helpful advice.

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