Sjogren's Syndrome

Sjogren's syndrome is an autoimmune disorder that has two common identifying symptoms: dry mouth and dry eyes, but it may progress to affect joints, skin and vital organs. Women are more likely to suffer from this condition and patients are usually diagnosed with the disorder after the age of 40. The cause of Sjogren's syndrome is unknown, although genetic components seem to put some individuals at greater risk for developing the disease. There is some evidence that Sjogren's syndrome may be triggered by a viral or bacterial infection. Often the syndrome occurs in patients who have another immune disorder, like rheumatoid arthritis or lupus.

Symptoms of Sjogren's Syndrome

Sjogren's syndrome affects mucous membranes and glands that secrete moisture like the salivary glands. In addition to dry gritty eyes and a mouth so dry that it may become difficult to speak or swallow, other symptoms of Sjogren's syndrome include:

• Swelling of the salivary glands
• Dry skin or rashes
• Vaginal dryness
• Ongoing dry cough
• Persistent fatigue
• Painful joints

While the original presenting symptoms of Sjogren's may appear to be more uncomfortable than serious, as the disorder progresses almost all systems of the body may be affected. Eventually, Sjogren's syndrome may attack additional parts of the body including the skin, joints, liver, kidneys, lungs, nerves and thyroid.

Diagnosis of Sjogren's Syndrome

Diagnosing Sjogren's syndrome may be difficult because the syndrome shares symptoms with several other disorders. For a patient to be definitively diagnosed with Sjogren's, several types of tests are required to detect the presence of the disease and to determine the extent to which it has affected vital organs, particularly the kidneys. These diagnostic tests include:

• Comprehensive blood tests
• Full eye examination
• Shirmer eye test for tear production
• Chest X-ray
• Biopsy of the lip
• Urine test to assess kidney function

Imaging tests to check the function of the salivary glands are also performed. These tests include a scintigraphy, which tests salivary gland function and a sialogram, which tests for saliva production.

Treatment of Sjogren's Syndrome

In mild cases, patients may be able to get symptomatic relief with over-the-counter remedies to relieve dry eyes or dry mouth. Most patients, however, require prescription medications, or in severe cases, surgical intervention. Medications prescribed for Sjogren's syndrome include three types:

• Systemic medication to relieve arthritic inflammation, usually an NSAID
• Medication to provide moisture for the eyes, mouth or vagina
• Autoimmune suppressant medication like methotrexate or cyclosporine

Other medication may be prescribed for patients with Sjogren's syndrome, including antifungal medication for yeast infections and Plaquenil, a drug that, although primarily used for patients with malaria, has been found to be effective in treating Sjogren's syndrome. For most patients, medication is helpful and, for many, symptoms of the disorder subside over time. When dry eye is not helped by medication, a simple surgical procedure on the tear ducts, known as punctal occlusion, can be a successful remedy.

Additional Resources

• MedlinePlus
• National Institutes of Health
• Centers for Disease Control and Prevention
• Eunice Kennedy Shriver National Institute of Child Health and Human Development
• U.S. Department of Health & Human Services
• U.S. National library of Medicine
• WebMD