Some helpful Notes on Sjogren's Syndrome from the Lupus Foundation of America
October 26, 2017
Sjogren’s syndrome (SS) is a chronic autoimmune disorder in which the moisture-producing glands do not function correctly; SS can also affect internal organs.
Sjogren’s syndrome is a relatively common disease, although often under-diagnosed. Sjogren’s syndrome can occur alone or in association with other autoimmune diseases, most commonly lupus and rheumatoid arthritis (RA).
Several studies have shown various differences between people with SS alone and those with SS and another connective tissue disease. Because of these differences, Sjogren’s syndrome is termed Primary Sjogren’s Syndrome when it occurs by itself and Secondary Sjogren’s Syndrome when associated with another connective tissue disease.
The diagnostic criteria for SS include:
Because the disease is mild in some people, the first signs of mucosal dryness may be present for years before the disease becomes clearly evident.
Symptoms of Sjogren’s Syndrome
The symptom most associated with SS is oral (mouth) dryness, known as xerostomia. Other oral symptoms may include:
Eye involvement is the other major manifestation of SS. People often complain of a sandy or gritty feeling in their eyes, especially in the morning. Other ocular symptoms that may be present include:
Symptoms that occur outside the glands are seen in one-third of people with primary SS, but rarely in those with secondary syndrome.
These extraglandular symptoms may include:
These symptoms and signs may be associated with lung involvement, kidney involvement, and vasculitis (inflammation of blood vessels). In addition, lymphomas (tumors of the lymph glands), will develop in 6 percent of people with primary SS who have systemic disease.
Laboratory abnormalities in Sjogren’s Syndrome
Autoantibodies are common in SS.
Certain genes may also be found more frequently in people with primary SS. These "histocompatibility antigens" may include HLA-B8 and HLA-DR3.
Diagnostic tests and procedures in Sjogren’s Syndrome
Several tests are commonly used to confirm a suspected diagnosis of SS:
Associations of Sjogren’s Syndrome with lupus and other disorders
The coexistence of Sjogren’s syndrome with lupus was first described in 1959. Since that report, numerous studies have compared and contrasted the two diseases. Many of the clinical and serological (blood-related) features of SS and lupus make the precise diagnosis difficult because there are similarities between the two diseases. It is not uncommon to find features of secondary SS in people with lupus. People with primary SS and people with lupus have certain similar disease symptoms, including arthritis, skin rash, and kidney disease. Increased levels of antinuclear antibodies are also seen in both diseases.
In some cases, an increased association of certain genes is found in individuals with both primary SS and lupus.
Sjogren’s syndrome may also be confused with disease processes, such as viral infections and drug side effects (dryness from various antihypertensive agents, antidepressant agents or antihistamine agents, etc.).
Other disease processes may also cause salivary gland enlargement are viral infections, sarcoidosis, and diabetes.
Treatment for Sjogren’s Syndrome
Treatment for Sjogren’s syndrome attempts to relieve the effects of chronic dryness of the mouth and eyes by increasing the lubrication and moisturization of the affected tissues:
(Editor - Check all issues related to your medication and prescriptions with your doctor)
Prognosis of Sjogren’s Syndrome
The overall disease course of Sjogren’s syndrome can vary from very mild to fairly significant.. As previously noted, people with primary SS seem to have a greater chance of extraglandular involvement.
Early diagnosis and early treatment are extremely important in trying to prevent damage to major organs.
Learning as much as possible about the disease process will enable individuals with commonly associated diseases to be aware of problems and symptoms.
Routine follow-up with your doctor is very important.
The Lupus Foundation of America would like to thank Stuart Kassan, MD, for this information.