Sjogren Syndrome
(Primary Sjogren Syndrome; Secondary Sjogren Syndrome)
Definition
Sjogren syndrome is a disorder that causes the immune system to destroy the glands that make tears and saliva. There are two types:
- Primary—occurs alone
- Secondary—occurs with other rheumatic conditions such as rheumatoid arthritis, scleroderma, or lupus
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Causes
The cause is not known. Genetics, the environment, and hormones may play a role.
Risk Factors
This problem is more common in women. It usually starts in those who are 40 to 55 years of age.
Other things that may raise the risk are:
- Certain genetic markers
- Having other family members who have autoimmune diseases
- Viruses, such as Epstein-Barr virus and cytomegalovirus
Symptoms
Problems may be:
- Eyes that are red, burning, itching, and dry
- Dry mouth
- Problems swallowing
- Loss of taste and smell
- Dry skin, nose, and throat
- Swollen glands in the head
- Vaginal dryness in women
- Skin rashes
- Joint pain, swelling, and stiffness
- Muscle pain
- Lack of energy
Diagnosis
The doctor will ask about your symptoms and health history. A physical exam will be done. You may be referred to a specialist. You may also be referred to a dentist for an exam.
Your eyes may be tested. This can be done with:
- Schirmer test to measure tear production
- Slit-lamp exam
Blood tests will be done to look for antibodies linked to this syndrome.
Images of the salivary gland may be taken. This can be done with:
- Scintagraphy
- Sialography
- Ultrasound
Salivary gland tissue may need to be tested. This can be done with a biopsy.
Treatment
There is no cure. The goal of treatment is to manage symptoms. Choices are:
- Medicines to ease:
- Dryness
- Joint and muscle pain
- Swelling
- Lifestyle changes, such as drinking plenty of fluids and exercising regularly
People with severe dry eye may need surgery. A plug may be placed in the tear ducts to stop fluid from draining from the eyes.
Prevention
There are no known guidelines to prevent this health problem.
RESOURCES:
American Autoimmune Related Diseases Association, Inc.
http://www.aarda.org
Sjogren's Foundation
http://www.sjogrens.org
CANADIAN RESOURCES:
Health Canada
https://www.canada.ca
MyHealth.Alberta.ca
https://myhealth.alberta.ca/
REFERENCES:
Sjogren syndrome. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/sjogren-syndrome. Accessed March 2, 2021.
Sjogren's syndrome information page. National institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Sj%C3%B6grens-Syndrome-Information-Page. Accessed March 2, 2021.
Vivino FB. Sjogren's syndrome: Clinical aspects. Clin Immunol. 2017 Sep;182:48-54.
2/22/2017 EBSCO DynaMed Systematic Literature Surveillance https://www.dynamed.com/condition/sjogren-syndrome: Luciano N, Baldini, Tarantini G, et al. Ultrasonography of major salivary glands: a highly specific tool for distinguishing primary Sjögren's syndrome from undifferentiated connective tissue diseases. Rheumatology (Oxford). 2015;54(12):2198-2204.
8/1/2019 EBSCO DynaMed Systematic Literature Surveillance https://www.dynamed.com/condition/sjogren-syndrome: Singh JA, Cleveland JD. The risk of Sjogren's syndrome in the older adults with gout: A medicare claims study. Joint Bone Spine. 2019 Feb 7 [Epub ahead of print].
Last reviewed December 2020 by EBSCO Medical Review Board Kari Kassir, MD