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Sjogren's Syndrome


Statistics

  • Occurs in 2-4 million Americans.

  • 9 out of 10 people diagnosed with Sjogren's are female.

What is Sjpgren's Syndrome?

Pronounced SHOW-gren, Sjogren's Syndrome was first described in the early 20th century by Swedish physician Henrik Sjögren. It is divided into two classifications:

Primary Sjogren's syndrome occurs without presence of other autoimmune or connective tissue disease.

Secondary Sjogren's syndrome occurs with rheumatic diseases such as rheumatoid arthritis, systemic lupus erythematosus ("lupus"), polymyositis, and some forms of scleroderma. Approximately 50% of people with Sjogren's syndrome are described as having secondary Sjogren's syndrome.

What causes it?

Another immune system malfunction, Sjogren's is the attack on moisture producing glands by the body's own immune system, eventually destroying these glands. Sjogren's syndrome can also cause problems in other parts of the body, including the joints, lungs, muscles, kidneys, nerves, thyroid gland, liver, pancreas, stomach, and brain. What causes this malfunction is not yet known, however genetic, immunologic, hormonal, infectious factors are all suspected to be involved.

What are the symptoms?

The two most common symptoms are dry eyes and dry mouth. Dry nose, throat, and lungs, vaginal dryness, swollen salivary glands, and fatigue are also common. More severe cases can affect other parts of the body, such as blood vessels, the nervous system, muscles, skin, and other organs. This can lead to muscle weakness, confusion and memory problems, dry skin, and feelings of numbness and tingling.

How is it diagnosed?

Sjogren's can be difficult to diagnose. Many of the symptoms are also present in other, more common conditions. A doctor may rely on physical exam, medical history, blood tests and other tests to determine the diagnosis. A lip biopsy involves the removal of a few salivary glands from inside lip. The tissue is examined under a microscope to look for specific signs of sjogren's syndrome. Another test that may be done is called a shrimer's test. It involves placing a small piece of filter paper under the lower eyelid to measure the amount of tears produced.

How is it treated?

The main goal of treatment is to relieve discomfort and lessen the effects of the dryness. Since Sjogren's syndrome affects everyone differently, treatment plans will vary.

Medications:
NSAIDS (Nonsteroidal anti-inflammatory drugs) may be used to treat Sjogren's syndrome. Available over the counter or by prescription, they fight inflammation or swelling and relieve pain.

DMARDS (disease modifying anti-rheumatic drugs) are also known as SAARDS (slow acting anti rheumatic drugs. They may be used to treat severe cases of Sjogren's syndrome. As their name might suggest these medications take some time to be effective, up to several months.

Salagen® is a prescription drug that can increase the flow of saliva.

Personal Care:
Mouth care is essential when dealing with the dry mouth symptoms of Sjogren's syndrome. Sipping fluids throughout the day, using sugar-free gum or candies to stimulate saliva production work well to ease dry mouth. There are saliva substitutes or mouth coating products available without a prescription. Cavities are common in those with Sjogren's syndrome. Regular dental checkups and meticulous oral hygiene are extremely important.

Eyes are another area requiring special attention. Artificial tears or eye drops may help relieve the discomfort of dry eyes. Try lubricating ointments or small, long-acting pellets for overnight or long-lasting relief. Surgical insertion of silicon plugs into the tear ducts can help keep the eyes moist.

Treatments for vaginal dryness, dry skin and other symptoms of Sjogren's Syndrome may be used as needed. Many can be purchased over the counter.

What research is being done?

As researchers delve into the cause of other immune system malfunctions, they are also getting closer to pinpointing the cause of Sjogren's Syndrome.

Some of the related information found on Arthritis Insight:

For support visit our Chat Room and Message Boards.
For medication information see our Medication Index.
For information about tests and blood work go to Tests & Labs.
For more sites about Sjogren's Syndrome check out our Web Links.

For more information:

Sjogren's Syndrome Foundation 
University of Washington - Sjogren's Syndrome 
MedicineNet - Sjogren's Syndrome 
Dry.org


References:
American College of Rheumatology
Sjogren's Syndrome: Editor: Frederick Matsen III MD Chairman, Department of Orthopaedics, University of Washington, Seattle, USA
Sjogren's Syndrome Foundation