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Sjogren's Syndrome - 10 Things You Should Know

From Early Symptoms to Disease Management

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Updated February 24, 2013

Primary Sjogren's syndrome occurs in patients who have no other rheumatic disease. Secondary Sjogren's syndrome develops in patients who do have another rheumatic disease, usually lupus or rheumatoid arthritis.

Sjogren's syndrome is a treatable condition. With effective treatment, most Sjogren's syndrome patients can live well. Much more is now known about Sjogren's syndrome than when it was discovered by Henrik Sjogren in the early 20th century. Here are 10 things you should know about Sjogren's syndrome.

1 - Sjogren's syndrome is an autoimmune disease.

People with Sjogren's syndrome have abnormal proteins in their blood indicating that the immune system is reacting against its own tissues of the body (autoimmune reaction). Sjogren's syndrome is also considered an inflammatory condition that can affect different parts of the body.

2 - Sjogren's can affect people of any age. More women than men develop Sjogren's syndrome.

Approximately 1 to 2 percent of the population (1 to 4 million Americans) have been diagnosed with Sjogren's syndrome. Symptoms usually develop between 45 and 55 years of age. Sjogren's syndrome is much more prevalent in women than men, with 10 times more women than men developing the condition. It is estimated that nearly half of all Sjogren's syndrome patients also have rheumatoid arthritis or one of the other connective tissue diseases like lupus.

3 - Though Sjogren's syndrome can affect different parts of the body, typically Sjogren's syndrome affects the tear and salivary glands.

The result of tear and salivary gland involvement is dry eye and dry mouth -- the most common symptoms associated with Sjogren's syndrome. Patients with dry eye experience irritation, burning, or the feeling of grit in the eye. Dry mouth can make it difficult to swallow certain foods. Some Sjogren's syndrome patients also experience dryness of the skin, vagina, nasal passages, and throat.

4 - Decreased tears and saliva (dry eye and dry mouth) can cause an increased risk of eye and dental problems.

Patients who suffer with dry eyes are at increased risk of eye infections or infections around the eye. Dry mouth can cause dental decay, gingivitis, and thrush (oral yeast infection). It is very important for Sjogren's syndrome patients to have regular checkups with an opthalmologist and dentist.

5 - There are other complications that may be associated with Sjogren's syndrome, though they are considered more rare.

Rare complications linked to Sjogren's syndrome include:

  • pain, stiffness, mild swelling in the joints even in patients who do not have rheumatoid arthritis or lupus
  • rashes on arms and legs related to vasculitis
  • inflammation in the lungs, liver, and kidney
  • neurological complications resulting in numbness, tingling, and weakness
  • lymphoma in a small number of patients

6 - Because dry eye and dry mouth are not symptoms that are exclusive to Sjogren's syndrome, other specialized tests may be needed to help diagnose the condition.

Along with the usual medical history, physical examination, and blood tests, certain special tests that may be ordered include:

  • Schirmer test - doctor puts paper strips under lower eyelids and measures wetness on the paper after 5 minutes
  • slit lamp exam - performed by an opthalmologist using equipment to magnify and examine the eye, checking for dryness and inflammation
  • staining with vital dyes - checking for damage to the surface of the eye
  • mouth exam - the doctor observes the mouth for abnormalities and may obtain a saliva sample for quality check
  • lip biopsy - doctor removes tiny salivary glands from lower lip and examines them under a microscope

7 - There are antibodies found in the blood of Sjogren's syndrome patients. Their presence helps formulate the diagnosis.

Rheumatoid factor is not only present in rheumatoid arthritis patients. It may be present in Sjogren's syndrome patients or other autoimmune disease patients too. Positive ANA tests also may point to Sjogren's syndrome, as well as other autoimmune diseases. There are, however, specific antinuclear antibodies that occur commonly in Sjogren's syndrome patients, though not all. The specific Sjogren's syndrome antibodies are known as: anti-SS-A and anti-SS-B (also referred to as anti-Ro and anti-La respectively).

8 - Treatment of Sjogren's syndrome is very individual and depends on what body parts are affected. The goal of treatment is to relieve symptoms.

Dry eyes are helped by using artificial tears. Dry mouth can be relieved with saliva stimulants and mouth lubricants. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to manage joint pain. Corticosteroids may be prescribed to control inflammation if their is systemic (e.g., organs) involvement. Disease-modifying anti-rheumatic drugs (DMARDs) can be used to control an overactive immune system.

9 - Though dry eye and dry mouth are primary symptoms of Sjogren's syndrome, there are many causes for dry eye and dry mouth.

Certain medications, taken for other conditions, can cause dryness. It's important to not jump to conclusions because you are experiencing dry eyes or dry mouth. If you have these symptoms, see a doctor for a thorough evaluation and diagnosis.

10 - Don't forget the simple ways to manage dry eyes and dry mouth.

For dry eyes, blink your eyes to moisten them. Blink 5 or 6 times a minute. Protect your eyes from wind and drafts. Be sure to use a humidifier in your home. Avoid smoke, and avoid eye makeup that can be irritating. Similarly, there are common sense tips for managing dry mouth. Chew gum or suck on hard candy. Sip water throughout the day. Use lip balm to soothe dry lips.

Sources:

Sjogren's Syndrome. Health Information. NIAMS. December 2006.
http://www.niams.nih.gov/Health_Info/Sjogrens_Syndrome/default.asp

Sjogren's Syndrome. American Collegee of Rheumatology. April 2004.
http://www.rheumatology.org/public/factsheets/sjogrens_new.asp?aud=pat

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