In 1933, Swedish physician Henrik Sjögren observed a large number of his
female patients were experiencing dry eyes and mouths along with their arthritis
symptoms. The condition became known as Sjögren’s syndrome.
Sjögren’s syndrome is an arthritis-related disease that can affect several
organs. Its most common effect is on the moisture-producing glands, including
those of the eyes and mouth. It can cause extremely dry eyes (sometimes described
as the feeling of sand in the eyes or a burning sensation), extremely dry mouth and
throat, dental cavities from lack of saliva, enlarged glands near the jaw, vaginal
dryness and fatigue, as well as joint pain, stiffness and swelling. Less common
symptoms include rashes, numbness, and inflammation of the lungs, kidneys or liver.
What Causes It?
Sjögren’s syndrome is an autoimmune disease, a condition characterized by
the body’s inability to distinguish healthy cells from foreign substances. In
Sjögren’s, a type of white blood cell known as a lymphocyte attacks
moisture-producing glands, such as tear and salivary glands, and in some cases the
lungs, kidneys, liver, skin, nerves or joints.
Sjögren’s affects an estimated two to four million Americans. It is
considered primary when it occurs alone. Primary Sjögren’s causes salivary
gland swelling, lung, liver, nerve and skin involvement, as well as dry eyes and
dry mouth. Most cases are secondary, meaning they occur along with other
autoimmune diseases, such as rheumatoid arthritis or lupus.
Who Gets Sjögren’s?
A major risk factor for developing Sjögren’s is being a postmenopausal
woman. It occurs less commonly in younger women, children and men of any age.
Other risk factors include having:
an autoimmune disease, such as lupus, vasculitis, thyroid disease or
scleroderma.
a family member with Sjögren’s.
How is Sjögren’s Diagnosed?
Sjögren’s syndrome cannot be solely diagnosed by the presence of dry eyes
and dry mouth. Many other diseases, such as sarcoidosis, can cause signs that
resemble Sjögren’s. Also, side effects of certain medications (tricyclic
antidepressants, antihistamines and radiation treatments of the head and neck)
can mimic the dry eyes and dry mouth symptoms of Sjögren’s syndrome.
Diagnosis is based on a complete physical examination, medical history evaluation
and the following tests:
Eyes
Slit-lamp test to detect damage to the surface of the eye from eye
dryness by using a dye that exposes eroded areas of the conjunctiva
(the membrane that covers the eye and lines the inside of the eyelids).
Schirmer test to reveal the degree of dryness in the eyes by placing a small strip of filter paper beneath the lower lid and measuring the amount of tears produced.
Mouth
Lip biopsy to show inflammation of the salivary glands.
Blood
Blood tests to detect antibodies, such as rheumatoid factor, ANA, anti-SSA or anti-SSB, which are associated with primary Sjögren’s syndrome.
How is Sjögren’s Treated?
There is no cure for Sjögren’s, but it can be treated effectively. Treatment typically involves medications and other measures that relieve the common symptoms of the condition. Exercise and proper nutrition may help with the fatigue often associated with Sjögren’s syndrome.
In addition, drinking water frequently, avoiding cigarette smoke, brushing with fluoride toothpaste after every meal and having frequent dental check-ups can keep symptoms under control.
Following are treatments for some of the specific symptoms of Sjögren’s syndrome:
- Prescription or over-the-counter (OTC) artificial tears and eye drops help with the discomfort of dry eyes by lubricating the surface of the eyes.
- Water, sugar-free gum or candy and prescription or OTC mouth gels, tablets and sprays may relieve mouth dryness by stimulating salivary glands or moistening the mouth.
- Glucocorticoids (such as prednisone) may be prescribed if muscles, nerves or lungs are affected.
- Nonsteroidal anti-inflammatory drugs help reduce joint pain and stiffness and ease muscle aches.
- Hydroxychloroquine (Plaquenil) helps relieve joint pain, rashes and fatigue.
- Estrogen creams can ease vaginal dryness common to Sjögren’s and may relieve pain during intercourse.
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FOR MORE INFORMATION CONTACT
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your local chapter of the Arthritis Foundation for a free brochure on Sjögren’s.
the Sjögren’s Syndrome Foundation at 800/4-SJOGRENS or www.sjogrens.org.
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Sjögren's Syndrome
