Sjögren’s syndrome is a long-term autoimmune disease where the body’s immune system attacks its own tissues. It specifically targets the glands that produce moisture, like the tear and salivary glands, leading to a reduction in fluids. While this condition is known for causing dryness, its effects can be widespread, impacting other organs. The disorder can develop on its own or in conjunction with other autoimmune conditions.
Symptoms of Sjögren’s Syndrome
The most recognized indications of Sjögren’s syndrome are related to dryness. This includes dry eyes, which cause a gritty or burning sensation and light sensitivity. A dry mouth is another primary symptom that may lead to difficulty swallowing or speaking, a change in taste, and a higher rate of dental cavities. Dryness can also affect the skin, nasal passages, and throat, resulting in a persistent cough.
Beyond dryness, Sjögren’s can present with systemic symptoms. Many individuals experience profound fatigue and chronic pain in their joints and muscles. Skin rashes and swelling of the salivary glands behind the jaw are also common. The condition is classified as “Primary Sjögren’s” when it occurs alone, or “Secondary Sjögren’s” when it develops with another autoimmune disease like rheumatoid arthritis or lupus.
Understanding the Causes
The precise reason for the immune system malfunction in Sjögren’s syndrome is not fully understood, but research points to a multifactorial origin. It is widely believed that the condition arises from a combination of genetic and environmental factors. An individual may have a genetic predisposition that makes them more susceptible, which may then be activated by a trigger like a viral or bacterial infection. The female hormone estrogen may also have a role, as the condition is more common in women and often begins around menopause.
How Sjögren’s is Diagnosed
Diagnosing Sjögren’s syndrome can be complex as its symptoms often overlap with other conditions. A rheumatologist coordinates the diagnosis using a physical examination, patient symptoms, and specific tests, as no single test is definitive. Blood tests are used to detect antibodies like anti-SSA (Ro), anti-SSB (La), antinuclear antibodies (ANA), and rheumatoid factor (RF).
Eye examinations by an ophthalmologist are also common. The Schirmer test measures tear production, while special dyes reveal corneal damage from dryness. To assess salivary gland function, a doctor may measure saliva production or perform a lip biopsy, examining the tissue for inflammatory cell clusters.
Treatment and Management Strategies
There is no cure for Sjögren’s syndrome, so treatment focuses on relieving symptoms and managing complications. Management combines lifestyle adjustments, over-the-counter products, and prescription medications. Using a humidifier and avoiding dry environments can be beneficial.
For symptom relief, artificial tears and ointments address dry eyes, while sipping water or using saliva substitutes help with dry mouth. If these are insufficient, a doctor may prescribe medications that stimulate saliva or tear production, such as pilocarpine or cevimeline.
For systemic symptoms like joint pain, nonsteroidal anti-inflammatory drugs (NSAIDs) are used. If the disease affects major organs, medications that regulate the immune system are prescribed, such as hydroxychloroquine for joint pain and rashes or other immunosuppressive drugs for severe cases.
Potential Long-Term Complications
A persistent lack of saliva significantly increases the risk for dental problems. This includes a higher rate of cavities, as saliva helps protect teeth from bacteria, and oral yeast infections like thrush.
Severe, unmanaged dry eye can lead to vision problems, including damage to the cornea. The autoimmune attack can also extend beyond the moisture-producing glands to affect internal organs like the kidneys, lungs, or nervous system. This can lead to conditions like peripheral neuropathy. People with Sjögren’s also have a higher risk of developing lymphoma, a cancer of the lymph system, which requires long-term monitoring.