Sjogren's Syndrome

Sjogren's syndrome, more than just a dry mouth and dry eyes, is an autoimmune disease. In people with an autoimmune disease, the person's white blood cells attack healthy tissue. In the case of Sjogren's, the white cells attack the moisture producing glands.


In addition to dry mouth and eyes, Sjogren's can also affect other organs, blood vessels, the central nervous system and even increases the risk of developing lymphoma.


The symptoms of Sjogren's may include dry mouth, increased cavities, gum disease, swallowing difficulty, dry eyes with a gritty sensation leading  possible eye infections, inflammation of the airways leading to infection and even vaginal dryness and infections.


Sjogren's symptoms are not isolated to the moisture producing glands. This disease also causes extreme fatigue, joint pain, Raynaud's syndrome and an increased risk of developing lymphoma.


Since many of the symptoms of Sjogren's can mimic those of many other diseases, diagnosis is often delayed. To complicate matters, Sjogren's may occur alone, known as primary Sjogren's or in conjunction with other autoimmune disease like Rheumatoid Arthritis or Lupus.


Diagnosis involves observing clinical features of dry eyes and mouth and possibly Schirmer tear test strips to confirm reduced tear production. Salivary glands may become enlarged and feel firmer on palpation than normal glands. Salivary gland scans may also be done to detect inflammation. A salivary gland biopsy may also be done under local anesthesia.



Lab work may reveal a positive ANA (antinuclear antibodies), SS-A and SS-B antibodies (Sjogren's syndrome A and B antibodies), rheumatoid factor, thyroid antibodies and others. The sufferer may also have anemia and abnormal inflammation markers. 


Most treatment is directed at managing symptoms. Artificial tears, Restasis, lacrimal plugs are all ways to manage dry eyes. Dry mouth may be managed by increasing fluid intake, Biotene sprays and mouthwashes, and Salagen are all ways to manage oral dryness. Nasal dryness may be helped by using nasal saline sprays. If vaginal dryness is a problem, a lubricant should be used during sexual intercourse.


Additionally, hydroxychloroquine (Plaquenil) may help with fatigue, muscle and joint pains. If the patient develops vasculitis, the patient may require immunosuppressive drugs like prednisone, azathioprine or cyclophosphamide.


Prognosis for the patient with Sjogren's is usually very good but the patient must work closely with the ophthalmologist and dentist. Exceptional oral hygiene is imperative to prevent dental issues and prevention of corneal abrasions is important to promote eye health and prevent vision problems.