Sjogren’s syndrome is a relatively common autoimmune disease that mainly affects the eyes and salivary glands, but can affect different parts of the body. Immune system cells, called lymphocytes, and autoantibodies attack the body’s moisture-producing glands. This results in dryness of the mouth, eyes or other tissues.
The disorder may progress slowly, so the typical symptoms of dry eyes and mouth may take years to show. However, rapid onset can also occur. Symptoms can be mild, moderate or severe, and the progression is often unpredictable.
Women are most commonly affected by Sjogren’s syndrome. There is no cure, but the disorder can be managed. Sjogren’s syndrome is not usually life-threatening. However, in rare cases, organs such as the liver and kidneys may be involved, which can increase the severity of the condition. In a small number of people, Sjogren’s syndrome may be associated with lymphoma (cancer of the lymph glands).
Cause of Sjogren’s syndrome
No one knows what prompts the immune system to attack the tear and salivary glands. Around half the people who have Sjogren’s syndrome also have rheumatological conditions (such as scleroderma, lupus and rheumatoid arthritis). This is known as secondary Sjogren’s syndrome.
In the remaining cases, the autoimmune response occurs in isolation. This is known as primary Sjogren’s syndrome. It is believed to have a genetic basis and to be triggered by an environmental factor – possibly a virus.
Symptoms of Sjogren’s syndrome
The more common symptoms of Sjogren’s syndrome can include:
- dry eyes (including irritation, gritty feeling or painful burning)
- dry mouth (or difficulty eating dry foods)
- difficulty with chewing or swallowing
- swelling and tenderness of the glands around the face, neck, armpits and groin
- tiredness (fatigue)
- joint pain and general achiness
- other symptoms including headaches.
Other areas can be affected
All instances of Sjogren’s syndrome are systemic, which means they affect the entire body. Sjogren’s syndrome can be mild, moderate or severe. It can progress unpredictably and some people experience a remission of symptoms.
Common complications include dental decay, skin rashes and an increased susceptibility to thrush infections of the mouth. See your doctor promptly if you notice excessive redness and pain in the eyes as this could be a sign of infection. In some people, the disorder affects other areas of the body.
The mucus membranes of the nose and vagina can dry out and internal organs (including kidneys, intestines, lungs, heart and liver) may become inflamed. The structures of the circulatory and nervous systems can also be affected.
Diagnosis of Sjogren’s syndrome
Early diagnosis and treatment are important for preventing complications. Diagnosis of Sjogren’s syndrome can be difficult, since the symptoms can imitate those of other diseases such as lupus and fibromyalgia. Dry mouth and eyes can also be the side effects of medications for other problems, such as depression and high blood pressure.
Diagnosing Sjogren’s syndrome is often done by a rheumatologist (an arthritis and musculoskeletal specialist) and involves a number of tests, which may include:
- Schirmer’s test – special blotting paper held to the eye is used to assess the degree of tear production
- eye examination – including the use of special dyes
- biopsy – a small tag of salivary gland tissue is removed (usually from the lip) and examined in a laboratory
- blood tests – a series of blood tests may be performed to check the levels of particular immune system cells and immunoglobulins and for autoantibodies in the blood.
Treatment for Sjogren’s syndrome
There is no cure for Sjogren’s syndrome, but the disorder can be managed. Treatment may include:
- artificial tears and lubricating ointments for the eyes, it is best to use products that are preservative free
- artificial saliva
- mouth rinses and lozenges
- nasal sprays
- vaginal lubricant lotions
- moisturising lotion for the skin
- non-steroidal anti-inflammatory drugs (NSAIDs)
- corticosteroid medications
- immunosuppressive medications.
Management of Sjogren’s syndrome
Other suggestions to manage the symptoms of Sjogren’s syndrome include:
- Avoid dry and dusty environments.
- Avoid air drafts or windy weather.
- Wear protective glasses when outside in the wind and sun.
- Exercise regularly, eat a healthy diet, stop smoking and reduce stress to help your overall health and wellbeing.
- Eat soft, moist foods if you have trouble swallowing.
- Eat smaller, more frequent meals to stimulate saliva flow.
- Avoid salty, acidic or spicy foods and carbonated drinks that may be painful if your mouth is dry.
- Drink water regularly.
- Practice good dental hygiene and visit your dentist often.
Where to get help
- Your doctor
- Ophthalmologist (eye doctor)
- The Musculoskeletal Help Line Tel.1800 263 265
- Support groups
- Arthritis and Osteoporosis Victoria Tel. (03) 03 8531 8000 or 1800 263 265
Things to remember
- Sjogren’s syndrome is an autoimmune disease that mainly affects the eyes and salivary glands, but can also affect other parts of the body.
- Immune system cells attack the tear (lachrymal) and salivary glands.
- There is no cure, but the condition can be managed with medications and products such as artificial tears and saliva as well as mouth washes and lozenges.
This page has been produced in consultation with and approved by:
MOVE muscle, bone & joint health
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