What Is Sjögren's Syndrome?
Sjögren’s syndrome is a type of autoimmune disorder in which, for reasons unknown, the body’s defenses against infection mistakenly attack cells in the salivary and lacrimal (tear) glands. The result is extreme dryness in the mucous membranes of the mouth and eyes, which may lead to dental cavities and corneal infections. Other glands may be affected too, such as those that produce vaginal lubrication. Vaginal dryness is thus a symptom in women, who develop Sjögren’s syndrome nine times more often than men.
Nearly 60 percent of patients may develop other, nonglandular symptoms (such as fatigue and joint and muscle pain) over the course of the disease. The lungs, kidneys, blood vessels and nervous system may also be affected, but less often. Lymph glands often become enlarged, and Sjögren’s patients have a higher incidence of lymphoma. The disorder may occur on its own or in conjunction with other autoimmune disorders; in fact, as many as 30 percent of those with rheumatoid arthritis also develop Sjögren’s syndrome.
Sjögren’s syndrome can begin at any time in life, including childhood, but typically starts after age 40. In uncomplicated cases symptoms can be eased with treatment, and the outlook is generally favorable.
What Causes Sjögren’s Syndrome?
- The cause of Sjögren’s is unknown, although a hereditary predisposition appears to be involved.
- Other autoimmune disorders are linked to a higher risk of Sjögren’s
Symptoms of Sjögren’s Syndrome
- Dry, red, painful eyes
- Dry, painful mouth; swallowing difficulty; frequent dental cavities
- Reduced ability to distinguish taste and smells
- Hoarseness and dry cough that worsens in cold weather
- Dry skin
- Dry nose
- Swelling of the salivary glands just in front of the ears (parotid glands)
- Vaginal dryness
- Joint pain
- Sore or cracked tongue
- Digestive problems
- There is no way to prevent Sjögren’s syndrome.
Diagnosis of Sjögren’s Syndrome
- Patient history and physical examination.
- Blood tests for indicators of autoimmune activity.
- Biopsy and microscopic examination of a tissue sample from the salivary glands or lip.
- A Schirmer test (placement of small pieces of paper between the lower eyelid and eyeball) may be performed to see how much moisture is being produced.
How to Treat Sjögren’s Syndrome
- There is no cure for Sjögren’s syndrome; treatment is aimed at relieving symptoms.
- Artificial tear solutions containing methylcellulose or saline eyedrops are used to treat dry eyes.
- Sugarless gum or sour candies may increase saliva.
- Increased fluid intake is important, but alcohol and caffeine can exacerbate dryness.
- Saliva-substitute solutions, which also contain methylcellulose, may be recommended. In severe cases the drugs pilocarpine or cevimeline may be prescribed to increase saliva production.
- Vigilant dental hygiene is essential for the prevention of cavities.
- Antibiotics may be prescribed to treat associated bacterial infections in the eyes or eyelids.
- Over-the-counter water-based lubricants can be used to counteract vaginal dryness. Your doctor may recommend using a gel containing propionic acid.
- For dry skin, moisturizing creams should be applied right after bathing, while skin is still moist.
- In very severe cases corticosteroids such as prednisone or short-term courses of immunosuppressive drugs may be administered to treat life-threatening vital organ involvement, but this is uncommon.
When to Call a Doctor
- Make an appointment with a doctor if you develop persistent dryness in the mucous membranes of the eyes, mouth, nasal passages or vagina.
Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference
Simeon Margolis, M.D., Ph.D., Medical Editor
Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50
Updated by Remedy Health Media