Sjogren's syndrome is an autoimmune, inflammatory disease which can occur as a primary condition with no other rheumatic disease or as a secondary condition along with another rheumatic condition.
In the early 1900s, Henrik Sjögren, a Swedish doctor described women with chronic arthritis symptoms who also had dry eyes and dry mouth. The syndrome was named after Dr. Sjögren. Since that time much more has been learned about the syndrome and how to treat it.
The cause of Sjogren's syndrome remains unknown. However, it is recognized as an autoimmune disease and according to the American College of Rheumatology, genetic factors and possibly viral infections may increase the risk of developing the syndrome. Hormones may also be a factor.
According to the Sjogren's Syndrome Foundation (SSF), symptoms may include:
- Dry eyes which may also feel gritty or burning
- Difficulty chewing, swallowing and talking
- Cracked or sore tongue
- Dry, burning throat
- Difference in taste or smell
- Dental decay
- Oral yeast infections
- Joint pain
- Digestive difficulties
- Dry nose and skin
- Swelling of glands around face
- Fatigue
Symptoms, in combination with findings from physical examination and certain diagnostic tests, help formulate the diagnosis of Sjogren's syndrome. No single test alone confirms the diagnosis.
Tests which help confirm the diagnosis, but are not conclusive in and of themself. A full doctor's exam is necessary.
- Antinuclear antibody (ANA test) - 70 percent of Sjogren's patients test positive for ANA, but the antibody may be present in healthy people, too.
- SSA (anti-Ro) and SSB (anti-La) - Antibodies found only in Sjogren's syndrome patients. But not all Sjogren's patients test positive for these.
- Rheumatoid factor - 60 to 70 percent of Sjogren's patients are rheumatoid factor positive.
- Immunoglobulins - normal blood proteins are elevated in Sjogren's
- Special ophthalmologic or dental tests may be ordered.
Treatment of Sjogren's syndrome focuses on decreasing symptoms. Dry eyes may be helped by using artificial tears, or medication to stimulate tear production (e.g. Restasis). Lacriserts (pellet placed in eyelid) is another treatment for dry eyes.
Drinking water, gum-chewing, or the use of saliva substitutes help dry mouth. Salagen and Evoxac are two prescription medications which stimulate saliva flow. Moisturizers can be used for dry skin conditions associated with Sjogren's syndrome. Lubricant jelly can treat vaginal dryness.
Anti-inflammatory drugs (e.g. NSAIDs, steroids) and immunosuppressants may be prescribed.
According to the Sjogren's Syndrome Foundation, Sjogren's syndrome is one of the most prevalent autoimmune conditions and affects as many as 4 million Americans. Ninety percent of Sjogren's syndrome patients are women. The average age of onset is upper 40s, but men, women, and children can develop Sjogren's syndrome at any age.
- The average time from symptom onset to disease diagnosis for Sjogren's syndrome is more than 6 years.
- About 50 percent of Sjogren's syndrome occurs alone.
- The other 50 percent of Sjogren's syndrome occurs with another condition, most likely rheumatoid arthritis, systemic lupus erythematosus, scleroderma, polymyositis, dermatomyositis.
- Rheumatologists manage Sjogren's syndrome patients while dentists and eye doctors may treat specific symptoms.
- Most people with Sjogren's syndrome can live normal lives with a few adjustments, according to the American College of Rheumatology.
- Rare complications can occur.
Sources:
1. "What is Sjogren's Syndrome?." About Sjogren's Syndrome. Sjogren's Syndrome Foundation. 26 Feb 2007 <http://www.sjogrens.org/syndrome/>
2. Wise M.D., Christopher. "Sjogren's Syndrome." April 2004. American College of Rheumatology. 26 Feb 2007 <http://www.rheumatology.org/public/factsheets/sjogrens_new.asp?aud=pat>
3. "Sjogren's Syndrome." Disease Center. Arthritis Foundation. 26 Feb 2007 <http://www.arthritis.org/conditions/DiseaseCenter/sjogrens.asp>
