Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.
The human body seems to be under almost constant attack from the outside world,
whether it is from harsh climate, from the sun's ultraviolet rays, or the
bacteria and viruses that surround us. So, it seems especially unfair when the
body attacks itself to cause illness. This is precisely what occurs in a group
of illnesses referred to as autoimmune diseases. Autoimmune diseases can affect almost
anyone, and the latest patient in the spotlight is Venus Williams, who withdrew
from the U.S. Tennis Open because of Sjögren's syndrome.
"I'm really disappointed to have to withdraw from this year's U.S. Open,"
Williams said in a statement. "I have recently been diagnosed with Sjögren's
syndrome, an autoimmune disease which is an ongoing medical condition that
affects my energy level and causes
fatigue and joint pain...I enjoyed playing my
first match here and wish I could continue, but right now I am unable to. I am
thankful I finally have a diagnosis and am now focused on getting better and
returning to the court soon." – Venus Williams in USA Today.
Sjögren's syndrome involves inflammation of glands
and other tissues of the body.
About 90% of Sjögren's syndrome patients are female.
Sjögren's syndrome can be complicated by infections
of the eyes, breathing passages, and mouth.
Sjögren's syndrome is typically associated with
antibodies against a variety of body tissues (autoantibodies).
Diagnosis of Sjögren's syndrome can be aided by a
saliva-gland biopsy.
Treatment of patients with Sjögren's syndrome is directed toward the particular areas of the body that are involved and complications, such
as infection.
What is Sjögren's syndrome?
Sjögren's syndrome is an autoimmune disease characterized by dryness of the
mouth and eyes. Autoimmune diseases feature the abnormal production of extra
antibodies in the blood that are directed against various tissues of the body.
The misdirected immune system in autoimmunity tends to lead to inflammation of
tissues. This particular autoimmune illness features inflammation in glands of
the body that are responsible for producing tears and saliva. Inflammation of
the glands that produce tears (lacrimal glands) leads to decreased water
production for tears and decreased saliva production and dry eyes. Inflammation of the glands that produce the saliva in the mouth (salivary glands, including the parotid glands) leads to dry mouth and dry lips.
Sjogren's syndrome with gland inflammation (resulting in dry eyes and mouth, etc.) that is not associated with another connective tissue disease is referred to as primary Sjögren's syndrome.
Sjögren's syndrome that is also associated with a connective tissue disease, such as
rheumatoid arthritis, systemic lupus erythematosus, or scleroderma, is referred to as secondary Sjögren's syndrome. Dryness of eyes and mouth, in patients with or without Sjögren's syndrome, is sometimes referred to as sicca syndrome.
What causes Sjögren's syndrome?
While the exact cause of Sjögren's syndrome is not known, there is growing scientific support for genetic (inherited) factors. The genetic background of Sjögren's syndrome patients is an active area of research. The illness is sometimes found in other family members. It is also found more commonly in families that have members with other autoimmune illnesses, such as systemic lupus erythematosus, autoimmune thyroid disease, type I diabetes, etc. About 90% of patients with Sjögren's syndrome are female.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid
contents of the stomach backs up into the esophagus. The symptoms of uncomplicated GERD are heartburn,
regurgitation, and nausea. Effective treatment is available for most patients with GERD.
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease of the skin, heart, lungs, kidneys, joints, and nervous
system. When only the skin is involved, the condition is called discoid lupus.
When internal organs are involved, the condition is called systemic lupus
erythematosus (SLE).
Dry mouth is a common side effect of many prescription and non-prescription drugs. Symptoms of dry mouth include a sticky, dry feeling in the mouth, frequent thirst, sores in the mouth; sores or split skin at the corners of the mouth, cracked lips, a dry feeling in the throat, a b urning or tingling sensation in the mouth, and a dry, red, raw tongue.
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of
arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout,
and pseudogout.
Raynaud's phenomenon is characterized by a pale-blue-red sequence of color changes of the digits, most commonly after exposure to cold. Occurring as a result of spasm of blood vessels, the cause is unknown. Symptoms of Raynaud's phenomenon depend on the severity, frequency, and duration of the blood vessel spasm. Treatments include protection of the digits, medications, and avoiding emotional stresses, smoking, cold temperature, and tools that vibrate the hands.
Hashimoto's thyroiditis is the most common cause of hypothyroidism in the US. This conditions is caused by inflammation of the thyroid gland. Symptoms may include: fatigue, weight gain, cold intolerance, excessive sleepiness, dry or coarse hair, difficulty swallowing, a lump in the front of the throat, and many more. Treatment is usually hypothyroid medication.
Scleroderma is an autoimmune disease of the connective tissue. It is characterized by the formation of scar tissue (fibrosis) in the skin and organs of the body, leading to thickness and firmness of involved areas. Scleroderma is also referred to as systemic sclerosis, and the cause is unknown. Treatment of scleroderma is directed toward the individual features that are most troubling to the patient.
Vasculitis is a general term for a group of uncommon diseases which feature inflammation of the blood vessels. Each form of vasculitis has its own characteristic pattern of symptoms. The diagnosis of vasculitis is definitively established after a biopsy of involved tissue demonstrates the pattern of blood vessel inflammation. Treatment is directed toward decreasing the inflammation of the arteries and improving the function of affected organs.
Dysphagia or difficulty in swallowing, swallowing problems. Dysphagia is due to problems in nerve or muscle control. It is common, for example, after a stroke. Dysphagia compromises nutrition and hydration and may lead to aspiration pneumonia and dehydration.
Dry eyes are caused by an imbalance in the tear-flow system of the eye, but also can be caused by the drying out of the tear film. This can be due to dry air created by air conditioning, heat, or other environmental conditions.
Primary Biliary Cirrhosis is a chronic disease characterized by progressive inflammation and destruction of small bile ducts within the liver. The bile ducts transport bile from the liver to the intestine for the absorption of fat and elimination of waste products. The causes of Primary Biliary Cirrhosis may involve autoimmunity, infection, or genetic predisposition, acting alone or in combination. There are many medications and treatment options available for those with this and other associated diseases of Primary Biliary Cirrhosis.
Connective tissue disease is when the body's connective tissues come under attack, possibly becoming injured by inflammation. Inherited connective tissue diseases include Marfan syndrome and Ehlers-Danlos syndrome. Systemic lupus erythematosus, rheumatoid arthritis, scleroderma, polymositis, and dermatomyositis are examples of connective tissue diseases that have no known cause.
Hoarseness (abnormal deep, harsh, raspy voice) is caused by a variety of conditions in which the larynx (voice box and vocal chords) are irritated or injured. Examples of causes of hoarseness include: laryngitis, straining the vocal cords by yelling or screaming, infections, GERD, allergies, and more. Treatment of hoarseness depends on the cause.
Many common eye disorders resolve without treatment and some may be managed with over-the-counter (OTC) products. It's important to visit a physician or ophthalmologist is the problem involves the eyeball itself or the condition hasn't improved after 72 hours of use of an eye-care OTC product.
Dry skin (xeroderma) may be caused by external factors, like cold temperatures, low humidity, harsh soaps, and certain medications, or internal factors, such as thyroid disease, diabetes, psoriasis, or Sjogren's syndrome. Symptoms and signs of dry skin include itching and red, cracked or flaky skin. The main treatment for dry skin is frequent, daily lubrication of the skin.
Burning mouth syndrome (BMS) is a condition that causes pain in the mouth. BMS may be caused by menopause, dry mouth or allergies. Signs and symptoms include tingling or numbness of the tip of the tongue, bitter or metallic taste, and dry or sore mouth. Treatment depends upon the cause of your burning mouth syndrome.
There are several types of intraoral X-rays, each of which shows different
aspects of teeth.
Bite-wing X-rays show details of the upper and lower teeth
in one area of the mouth. Each bite-wing shows a tooth from its crown to about
the level of the supporting bone. Bite-wing X-rays are used to detect decay
between teeth and changes in bone density caused by gum disease. They are also
useful in determining the proper fit of a crown (or cast restoration) and the marginal integrity of fillings.
Periapical X-rays show the whole tooth -- from the crown
to beyond the end of the root to where the tooth is anchored in the jaw. Each
periapical X-ray shows this full tooth dimension and includes all the teeth in
one portion of either the upper or lower jaw. Periapical X-rays are used to
detect any abnormalities of the root structure and sur...
The human body seems to be under almost constant attack from the outside world,
whether it is from harsh climate, from the sun's ultraviolet rays, or the
bacteria and viruses that surround us. So, it seems especially unfair when the
body attacks itself to cause illness. This is precisely what occurs in a group
of illnesses referred to as autoimmune diseases. Autoimmune diseases can affect almost
anyone, and the latest patient in the spotlight is Venus Williams, who withdrew
from the U.S. Tennis Open because of Sjögren's syndrome.
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