Definition

Sjogren's syndrome is an inflammatory disease. The immune system destroys cells in exocrine glands. It occurs most often in the tear and salivary glands. It is a lifelong condition. There are two types:

    
  • Primary Sjogren's syndrome—occurs alone
  • Secondary Sjogren's syndrome—occurs with other rheumatic conditions such as rheumatoid arthritis, scleroderma, or lupus
  • Salivary Glands

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    Causes

    The causes of Sjogren's are unknown. Contributing factors may include:

        
  • Viral infections
  • Environmental factors
  • Heredity
  • Hormones
  • Risk Factors

    Factors that increase your risk for Sjogren's include:

        
  • Sex: female
  • Age: 40-60 years old
  • Other rheumatic or autoimmune diseases
  • Certain gene markers
  • Symptoms

    Symptoms may include:

        
  • Red, burning, itching, and/or dry eyes
  • Dry mouth
  • Difficulty swallowing
  • Loss of taste and smell
  • Dry skin, nose, throat, and/or lungs
  • Swollen salivary glands
  • Severe dental cavities caused by dry mouth
  • Oral yeast infections
  • Vaginal dryness
  • Skin rashes
  • Joint pain, swelling, and stiffness
  • Muscle pain
  • Fatigue
  • In some cases, other parts of the body are affected as well. These include:

        
  • Blood vessels
  • The nervous system
  • Organs such as the lungs, liver, pancreas, kidneys, and thyroid
  • Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. You may be referred to a specialist.

    Your bodily fluids and tissues may be tested. This can be done with:

        
  • Blood tests
  • Urine tests
  • Lip biopsy
  • Your eyes may be tested. This can be done with:

        
  • Schirmer test
  • Slit-lap examination
  • Images may also be taken of your bodily structures. This can be done with a chest x-ray.

    Treatment

    There is no cure for Sjogren's. No treatment can restore the ability of the glands to produce moisture. The goal of treatment is to relieve symptoms.

    Treatments include:

    Medication

    To help relieve dryness:

        
  • Artificial tears, artificial saliva, and vaginal lubricants
  • Pilocarpine—ocular and oral dryness
  • Cevimeline—requires less frequent dosing than pilocarpine, may cause nausea
  • To relieve joint and muscle pain:

        
  • Aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs)
  • To relieve inflammation/swelling:

        
  • Plaquenil—antimalarial drug with anti-inflammatory properties
  • Steroids
  • Methotrexate—a steroid-sparing agent
  • Lifestyle Measures

        
  • Mild exercise can help relieve stiffness in the joints.
  • To help relieve dry mouth, sip liquids often and suck on sugar-free candies.
  • Brush, floss, and see your dentist regularly. This can help to prevent cavities.
  • Use unscented moisturizers to help relieve dry skin.
  • This condition is generally benign. However, people with severe cases are at increased risk for developing non-Hodgkin lymphoma. This is a cancer of the white blood cells. Your doctor will need to monitor you for this.

    Prevention

    There are no guidelines for preventing Sjogren's syndrome. The cause is unknown.