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Sjogren’s syndrome is an immune system dysfunction characterized by its two most prevalent symptoms, dry eyes and a dry mouth. It is named after Swedish ophthalmologist Henrik Sjögren, who originally described the disorder.
The mucous membranes and glands that produce moisture in your mouth and eyes are typically the first parts of the body to experience Sjogren’s syndrome, which causes less saliva and tears to be produced. Lupus and rheumatoid arthritis are two immune system disorders that frequently coexist with the condition.
Despite the fact that Sjogren’s syndrome can strike at any age, the majority of cases involve adults over the age of 40. Women are much more likely to have the condition. Symptom relief is the main goal of treatment.
Two types of Sjögren’s syndrome
- Primary Sjögren’s syndrome develops alone, not as a result of another medical problem.
- Secondary Sjögren’s syndrome occurs in addition to autoimmune conditions including lupus, psoriatic arthritis, and rheumatoid arthritis.
Symptoms
Sjogren’s syndrome primarily manifests these two symptoms:
- Dry eyes. It may hurt, itch, or feel like there is sand in your eyes.
- Dry mouth. It could be challenging to swallow or speak because your mouth may feel as though it’s full with cotton.
Some Sjogren’s syndrome sufferers also have one or more of the following conditions:
- Exhaustion
- Dry cough
- Losing a tooth or tooth decay
- Swollen salivary glands — notably the group placed below your jaw and in front of your ears
- Changes in sense of taste
- Stiffness, swelling, and joint pain
- Dry vagina
- Dryness of the skin or rashes
Causes
Sjögren’s syndrome is a medical condition characterized by an autoimmune response. Your body’s own cells and tissues are accidentally attacked by your immune system.
The cause of Sjogren’s syndrome in certain patients remains unknown to scientists. A triggering mechanism, such as infection with a specific virus or strain of bacteria, appears to be required in addition to certain genes that increase a person’s risk of developing the disorder.
Your immune system targets the glands that produce saliva and tears first when you have Sjogren’s syndrome. However, it can potentially harm other areas of your body, including the thyroid, lungs, liver, kidneys, skin, joints, and nerves.
Risk factors
The majority of people with Sjogren’s syndrome have one or more of the following risk factors:
- Age. Sjogren’s syndrome is typically identified in patients over the age of 40.
- Sex. Sjogren’s syndrome is substantially more common among women.
- Rheumatic disease. A rheumatic disease, such as lupus or rheumatoid arthritis, is frequently present in Sjogren’s syndrome patients.
Diagnosis
Because the signs and symptoms of Sjogren’s syndrome differ from person to person and can sometimes resemble those of other conditions, it can be challenging to diagnose. Some Sjogren’s syndrome symptoms and signs can also be confused with side effects of various medications.
Tests can help rule out other illnesses and help pinpoint a diagnosis of Sjogren’s syndrome.
Blood examination
Blood exam may be recommended by your doctor to look for:
- Antibodies frequently seen in Sjogren’s syndrome
- Markers of inflammatory problems
- Amounts of various blood cell types
- Signs of problems with your kidneys and liver
Eye examination
A test known as the Schirmer tear test allows your doctor to gauge how dry your eyes are. To gauge your tear production, a little piece of filter paper is positioned under your lower eyelid.
The surface of your eyes may also be examined by an ophthalmologist, using a slit lamp, a magnification tool. Drops that help you see corneal damage may be put in your eye by the practitioner.
Imaging tests
Your salivary glands’ function can be examined using specific imaging procedures.
- Sialogram. The salivary glands in front of your ears can be injected with dye to identify it using this specialized X–ray. This test reveals how much saliva enters your mouth.
- Salivary scintigraphy. This nuclear medicine test includes injecting a radioactive isotope into a vein, which is monitored for an hour to determine how rapidly it enters each salivary gland.
Biopsy
Additionally, your doctor might perform a lip biopsy to look for inflammatory cell clusters, which may be a sign of Sjogren’s syndrome. For this test, a little piece of tissue is taken from the salivary glands in your lip and inspected under a microscope.
Treatment
The damaged bodily parts will determine how Sjogren’s syndrome is treated. By using over–the–counter eyedrops and drinking more water on a regular basis, many people manage the dry eye and dry mouth caused by Sjogren’s syndrome. However, some people require prescription drugs or even surgery.
Medications
In accordance with your symptoms, your doctor might advise drugs that:
- Lessen eye inflammation. If you have moderate to severe dry eyes, your eye doctor might suggest prescription eyedrops like cyclosporine or lifitegrast.
- Produce more saliva. Saliva and occasionally tears can be produced more when using medications like pilocarpine and cevimeline. Sweating, stomach ache, flushing, and increased urination are examples of side effects.
- Manage certain complications. Nonsteroidal Anti–inflammatory Drugs (NSAIDs) or other arthritis medications may be helpful if you experience the symptoms of arthritis. Antifungal drugs should be used to treat oral yeast infections.
- Treat systemic symptoms. A medication used to treat malaria called hydroxychloroquine is frequently effective in treating Sjogren’s syndrome. Additionally, immune system suppressing medications such methotrexate may be administered.
Surgery
A modest surgery to plug the tear ducts that drain tears from your eyes (punctal occlusion) can help relieve your dry eyes. To assist keep your tears from drying out, collagen or silicone plugs are placed inside the tear ducts.
