Sjögren’s Syndrome is a chronic autoimmune disorder primarily characterized by the body’s immune system attacking its own moisture-producing glands. This leads to hallmark symptoms like dry eyes, dry mouth, and dry skin, but its impact can go far beyond these initial signs. Named after the Swedish ophthalmologist Dr. Henrik Sjögren, this condition can exist as a primary disorder or alongside other autoimmune diseases, such as rheumatoid arthritis or lupus.
This blog dives into a detailed overview of Sjögren’s Syndrome, including its causes, symptoms, risk factors, diagnostic methods, treatment options, and self-care strategies.
What is Sjögren’s Syndrome?
Sjögren’s Syndrome is an autoimmune disorder—meaning the body’s immune system mistakenly targets its own tissues. In this case, it predominantly affects the exocrine glands, which are responsible for producing tears and saliva. As a result, the most common symptoms are dry eyes and dry mouth, but the disease can also impact the skin, joints, lungs, kidneys, blood vessels, and nerves.
There are two main types:
Primary Sjögren’s Syndrome: Occurs independently, without the presence of another autoimmune disease.
Secondary Sjögren’s Syndrome: Occurs alongside other autoimmune conditions like lupus, scleroderma, or rheumatoid arthritis.
Common Symptoms of Sjögren’s Syndrome
The signs and symptoms can vary from person to person, but the most frequent ones include:
1. Dry Eyes or Itchy Eyes
Often described as a gritty or burning sensation, individuals may feel like they have sand in their eyes. The tear glands are damaged, reducing tear production and leading to chronic irritation or inflammation of the eyes.
2. Dry Mouth, Mouth Sores, or Thickened Spit
Lack of saliva can lead to difficulty speaking, chewing, or swallowing. It can also result in mouth sores, a sticky feeling in the mouth, and an increased risk of dental cavities, gum disease, and oral infections.
3. Vaginal Dryness
In women, vaginal dryness is a common symptom, potentially leading to discomfort during intercourse and an increased risk of vaginal infections.
4. Dry Skin
The skin may become itchy, flaky, or rough. In some cases, patients experience rashes or sensitivity due to decreased moisture and autoimmune-related inflammation.
5. Dry Nose and Frequent Nosebleeds
Reduced mucus secretion in the nasal passages can cause chronic nasal dryness, irritation, and frequent nosebleeds, which may be mistaken for allergy symptoms or environmental dryness.
6. Dry Throat and Frequent Coughing
The throat may feel dry, sore, or scratchy, sometimes accompanied by chronic cough or hoarseness due to inflammation or mucus gland damage.
Other Associated Symptoms
In addition to the above, patients may also experience:
Fatigue: A persistent, overwhelming tiredness not relieved by rest.
Swollen salivary glands, especially around the jaw and in front of the ears
Digestive issues, including acid reflux and bloating
Numbness or tingling in the hands and feet due to nerve involvement (peripheral neuropathy)
Kidney problems, such as interstitial nephritis
Lung complications, like interstitial lung disease
Causes and Risk Factors
The exact cause of Sjögren’s Syndrome is unknown, but several factors are thought to contribute:
1. Autoimmunity
The condition arises when the immune system malfunctions and begins attacking the body’s own moisture-producing glands.
2. Genetic Predisposition
There is evidence that genes play a role, particularly in families with a history of autoimmune conditions.
3. Hormonal Influence
Sjögren’s is significantly more common in women, especially those aged 40 to 60. Hormonal fluctuations during menopause may be a contributing factor.
4. Environmental Triggers
Viral or bacterial infections may trigger the immune system to misfire, although this is still under investigation.
Who is at Risk?
Women (about 9 in 10 patients are female)
People over the age of 40
Individuals with other autoimmune diseases (RA, lupus)
Family history of autoimmune conditions
How is Sjögren’s Syndrome Diagnosed?
Diagnosing Sjögren’s can be challenging, as its symptoms overlap with many other conditions. A combination of clinical evaluations, laboratory tests, and biopsies is used:
1. Blood Tests
To check for autoantibodies such as:
Anti-SSA (Ro)
Anti-SSB (La)
ANA (antinuclear antibodies)
Rheumatoid factor (RF)
2. Schirmer’s Test
A small strip of paper is placed under the eyelid to measure tear production.
3. Salivary Gland Function Tests
This may include imaging or a sialography to detect blockages or inflammation in the salivary glands.
4. Lip Biopsy
A minor biopsy of the inner lip is performed to detect lymphocytic infiltration in the salivary glands.
5. Eye Staining
Special dyes like fluorescein or lissamine green are used to assess eye surface damage due to dryness.
Complications of Sjögren’s Syndrome
Though not typically life-threatening, the condition can lead to serious complications if left untreated:
Dental decay and oral infections
Vision damage from chronic dry eyes
Yeast infections
Increased risk of non-Hodgkin’s lymphoma
Lung and kidney complications
Peripheral neuropathy
Thyroid dysfunction
Treatment Options
There is no cure for Sjögren’s Syndrome, but treatment focuses on symptom management and preventing complications.
1. Artificial Tears and Eye Gels
To relieve dry eyes.
2. Saliva Substitutes and Mouth Rinses
To keep the mouth moist and protect dental health.
3. Immunosuppressive Medications
Used to manage inflammation and systemic complications. These include:
Hydroxychloroquine
Methotrexate
Corticosteroids
Biologics (e.g., rituximab)
4. Moisturizers and Barrier Creams
To treat dry or itchy skin.
5. Pilocarpine or Cevimeline
These medications stimulate saliva and tear production.
Lifestyle and Self-Care Tips
1. Stay Hydrated
Drink plenty of water to keep tissues moist.
2. Use a Humidifier
This can help maintain moisture in your living environment, especially in dry climates.
3. Maintain Good Oral Hygiene
Brush and floss regularly. Visit your dentist more frequently for preventive care.
4. Protect Your Eyes
Wear sunglasses outdoors and avoid environments that irritate your eyes.
5. Use Vaginal Moisturizers
Over-the-counter products can help with vaginal dryness and improve comfort during intimacy.
6. Healthy Diet
Include omega-3 fatty acids, fruits, and vegetables. Avoid caffeine, alcohol, and tobacco, which can worsen dryness.
Living with Sjögren’s Syndrome
Chronic diseases like Sjögren’s can be physically and emotionally taxing. Joining a support group, staying informed, and having open communication with your healthcare provider are key to improving your quality of life.
Mental Health Support
Fatigue, pain, and isolation can lead to depression or anxiety. Therapy, mindfulness, and support networks can play a critical role in overall well-being.
Sjögren’s Syndrome may start with something as simple as dry eyes or mouth but can progress to involve various organs and systems if not properly managed. Recognizing the symptoms early, getting an accurate diagnosis, and beginning treatment can help prevent complications and improve quality of life.
The Sparsh Department of Rheumatology specializes in providing comprehensive diagnosis and treatment for various kinds of musculoskeletal diseases and systemic autoimmune conditions. Call our helpline number 9830117733 to make an appointment now.
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Disclaimer:
No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
