What is Sjögren's syndrome?
Sjögren's syndrome (say "SHOW-grins") is a disorder in which the immune system attacks the body's moisture-producing glands, such as the tear glands and the saliva glands. These glands may become scarred and damaged, and extreme dryness in the eyes and mouth (sicca syndrome) may develop. Sjögren's syndrome may also cause fatigue, pain in the joints, and, in rare cases, problems with the function of vital organs, such as the lungs, kidneys, and nerves.
Sjögren's syndrome is an autoimmune disease, in which a person's immune system attacks its own tissues as though they were foreign substances. Women and men of all races may develop this disorder. But Sjögren's is more common in white women who are in their 40s and 50s.
What causes Sjögren's syndrome?
The exact cause of Sjögren's syndrome is not known. A combination of genetic and environmental factors may cause this disorder. Heredity may be a factor, since Sjögren's syndrome sometimes runs in families. Hormones may play a role, since this disorder mostly affects women, but this relationship remains unclear.
What are the symptoms?
The most common symptoms of Sjögren's syndrome are extremely dry eyes and mouth that have persisted for at least 3 months and are not due to medicines. You may have itching and burning in your eyes, and your mouth may feel as though it is full of cotton.
Sjögren's syndrome may develop in a person who has a connective tissue disorder, such as rheumatoid arthritis, lupus, or scleroderma, and is then classified as secondary Sjögren's syndrome. Symptoms of primary (no other associated disorder) and secondary Sjögren's syndrome are the same.
The focus of this topic is primary Sjögren's syndrome.
How is Sjögren's syndrome diagnosed?
Your doctor may diagnose Sjögren's syndrome after taking your medical history, doing a physical examination, and noting symptoms of dry eyes and mouth. Next, he or she will ask whether you are taking any medicines such as antihistamines or antidepressants that could cause dry eyes and mouth. If needed, your doctor may order tests for tear flow, eye damage, saliva production, tissue damage, and blood antibodies to confirm a diagnosis of Sjögren's syndrome.
How is it treated?
Although there currently is no cure for Sjögren's syndrome, you and your doctor can work together to treat your symptoms. For example, you can use artificial tears to moisten your eyes, and you can use mouth lubricants and saliva substitutes to moisten your mouth and throat.
Learning about Sjögren's syndrome: | |
Being diagnosed: | |
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Ongoing concerns: | |
Living with Sjögren's syndrome: |
The most common symptoms of Sjögren's syndrome are extremely dry eyes and mouth that have lasted for at least 3 months and are not due to medicines. You may have itching and burning in your eyes, and your mouth may feel as though it is full of cotton.
Dry eyes | Dry mouth |
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People with Sjögren's syndrome may also notice:
Sjögren's syndrome may develop in a person who has a connective tissue disorder, such as rheumatoid arthritis, lupus, or scleroderma. In these cases, it is called secondary Sjögren's syndrome. When a person has Sjögren's and does not have a connective tissue disorder, it is known as primary Sjögren's syndrome. The symptoms of primary and secondary Sjögren's syndrome are the same. But it may be hard to tell the difference between symptoms caused by secondary Sjögren's syndrome and those caused by another connective tissue disorder.
If you have symptoms other than or along with those identified, it is possible you may have another autoimmune disease in addition to Sjögren's syndrome. Discuss all of your symptoms with your doctor so that you can be accurately diagnosed.
Most people with Sjögren's syndrome have chronic dryness of the eyes and mouth that stays with them throughout their lives. A few people develop symptoms in other parts of the body.
Though not common, serious complications involving major body organs (such as the lungs, nerves, kidneys, and liver) may develop as the disease progresses. A small percentage of people with Sjögren's have a slightly higher chance of developing cancer involving the lymphatic system, such as non-Hodgkin's lymphoma.
There are many other conditions with similar symptoms. Your doctor will review your symptoms and do laboratory tests to confirm a diagnosis of Sjögren's syndrome.
Sjögren's syndrome can affect many different body systems. Your family doctor or general practitioner can diagnose this disorder. Depending on your symptoms, you may be referred to a specialist or other health professional:
After taking your medical history and doing a physical examination, your doctor will assess your symptoms and may run certain laboratory tests to confirm a diagnosis of Sjögren's syndrome. He or she will ask you for a list of the medicines you take to determine whether they may be causing your symptoms or making your symptoms worse.
Criteria devised by a group of European doctors can be used to help diagnose cases of this disease and to identify cases in which a person has similar symptoms but has other medical problems that may be causing the symptoms. The following tests may help find inflammation of saliva gland tissue, decreased formation of tears or saliva, or certain substances in the blood:
Your doctor may do other tests to check for evidence of other autoimmune diseases that also may cause dry eyes and mouth and other symptoms not related to Sjögren's. These tests include:
There is no cure for Sjögren's syndrome. But treatment can help control your symptoms. Treatment options include not only medicines you can take to supplement tears and saliva but also things you can do at home to prevent eye damage and dental problems.
You can control your symptoms of Sjögren's syndrome, which are often distressing but are rarely disabling. Your doctor may suggest home treatment to:
Progression of Sjögren's syndrome varies by individual. Most people with this disease have chronic dryness of the eyes and mouth that lasts throughout their lives. Your doctor may suggest home treatment to:
If your symptoms fail to improve or get worse even with home treatment, your doctor may want to prescribe medicines or use other treatments.
Progression of Sjögren's syndrome is different for everyone. Most people with this disease have chronic dryness of the eyes and mouth that lasts throughout their lives. If your symptoms are not relieved by home treatment and medicines and your disease begins to affect other parts of the body, your doctor may prescribe stronger medicine or recommend surgery.
If tear substitutes don't ease your dry eyes, your doctor may perform a surgical procedure called punctal occlusion, in which he or she places temporary or permanent plugs in your tear ducts (lacrimal ducts) to help keep moisture in your eyes. These plugs keep your tears from draining away from the eyes and leaving them dry.
For joint pain, chronic inflammation in saliva and tear glands, or other serious symptoms, treatment may include:
Research to develop new medicines to treat the symptoms of Sjögren's syndrome is ongoing.
Sjögren's syndrome is a disease that causes dry eyes and dry mouth. The following steps and treatments can be very helpful in relieving your symptoms and improving the quality of your life. Also, getting plenty of rest, eating well, and doing mild exercise daily play an important role in successful home treatment of this condition.
It is common for women with Sjögren's syndrome to experience vaginal dryness and painful intercourse.
Vaginal moisturizing products help to replenish natural moisture and relieve discomfort. These products include:
Vaginal lubricants can make intercourse more comfortable for you by relieving the friction you might experience if you have vaginal dryness. But vaginal lubricants do not add moisture to the vagina and are not useful for everyday moisturizing. Look for a water-based lubricant instead of an oil-based lubricant, which can interfere with the vagina's natural cleansing process. Vaginal lubricants include:
Your fatigue may be related to another health problem. Sjögren's syndrome may increase your risk of thyroid problems (hypothyroidism or hyperthyroidism) and depression. Effective treatments for these health problems are available. You should see your doctor if you feel persistent fatigue.
Medicine safety
Several types of medicines can cause dryness or allergic reactions and can make your symptoms worse. Talk to your doctor if you are taking any of the following medicines, but continue to take them unless advised to stop by your doctor:
More research is needed to determine the benefits and risks of these alternative treatments for Sjögren's syndrome.2
Before using any treatment for your symptoms, consider the risks and benefits. If you decide to use an alternative medicine or supplement, follow these precautions.
For more information on alternative medicines and supplements, see the topic Complementary Medicine.
| Arthritis Society of Canada | |
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The Arthritis Society provides funding for arthritis research and offers information on patient care, public education, and self-management of arthritis. | |
| Canadian Ophthalmological Society | |
| 610-1525 Carling Avenue | |
| Ottawa, ON K1Z 8R9 | |
| Email: | cos@eyesite.ca |
| Web Address: | www.eyesite.ca/english/index.htm |
The Canadian Ophthalmological Society is an association of eye doctors dedicated to helping the public take good care of their eyes and vision. This group provides educational information on eye conditions and diseases and eye safety. | |
| Canadian Rheumatology Association | |
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| Newmarket, ON L3X 1L3 | |
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The Canadian Rheumatology Association is a professional organization of rheumatologists that promotes arthritis care and research in Canada through leadership, education, and communication. | |
Citations
- Jonsson R, et al. (2005). Sjögren's syndrome. In WJ Koopman, LW Moreland, eds., Arthritis and Allied Conditions: A Textbook of Rheumatology, 15th ed., vol. 2, pp. 1681–1705. Philadelphia: Lippincott Williams and Wilkins.
- Fox RI, et al. (2000). Update in Sjögren syndrome. Current Opinion in Rheumatology, 12(5): 391–398.
Other Works Consulted
- Fife RS, et al. (2002). Cevimeline for the treatment of xerostomia in patients with Sjögren's syndrome. Archives of Internal Medicine, 162: 1293–1300.
| By | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | Anne C. Poinier, MD - Internal Medicine |
| Primary Medical Reviewer | Andrew Swan, MD, CCFP, FCFP - Family Medicine |
| Specialist Medical Reviewer | Stanford M. Shoor, MD - Rheumatology |
| Last Revised | June 23, 2010 |
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