Sjögren's syndrome
Sjögren's syndrome is a chronic autoimmune disorder characterized by the body's immune system attacking the glands that produce tears and saliva, leading to significant dryness in the eyes and mouth, commonly referred to as sicca syndrome. The specific causes of this condition remain unclear, but factors such as viral infections, genetics, and hormonal influences may play a role. Symptoms can vary widely and often include dry eyes, dry mouth, blurred vision, recurrent mouth infections, swollen salivary glands, and extreme fatigue. Diagnosing Sjögren's syndrome can be challenging, as its symptoms may overlap with those of other diseases or medication side effects.
It predominantly affects women, with most patients being diagnosed in their mid-forties. Although there is no cure for Sjögren's syndrome, treatments focus on alleviating symptoms through moisture replacement therapies, such as eyedrops and saliva-stimulating medications, along with the use of immunosuppressive drugs in more severe cases. Despite the chronic nature of the condition, the prognosis for individuals with Sjögren's syndrome is generally favorable, as it is not typically considered life-threatening. Understanding this condition is essential for those experiencing its symptoms and seeking appropriate care.
Sjögren's syndrome
ALSO KNOWN AS: Dry eye/dry mouth or sicca syndrome
ANATOMY OR SYSTEM AFFECTED: Eyes, immune system, mouth
DEFINITION: An autoimmune disorder resulting in the loss of tears and saliva
CAUSES: Unknown; possibly viral infection, heredity, hormones
SYMPTOMS: Dry eyes, dry mouth, blurred vision, eye discomfort, recurrent mouth infections, swollen salivary glands, hoarseness, difficulty swallowing and eating, extreme fatigue
DURATION: Chronic
TREATMENTS: Moisture replacement (eyedrops, saliva-stimulating drugs, salivary packets); immunosuppressive drugs or NSAIDs
Causes and Symptoms
Sjögren’s syndrome is a chronic autoimmune disease in which the body’s own immune cells attack and eliminate the glands that produce tears and saliva. This results in dryness of the eyes and mouth and is referred to as sicca syndrome. The causes of Sjögren’s syndrome are not known, although evidence suggests that viral infection, heredity, and hormones may be involved. Sjögren’s syndrome is one of the more prevalent autoimmune disorders. Nine of ten patients with Sjögren’s syndrome are female.
Sjögren’s syndrome can be difficult to diagnose, because the symptoms are similar to those caused by other diseases. The symptoms can also mimic the side effects associated with a number of medications and may vary from individual to individual. Even when the symptoms are reported to a physician, dentist, or eye specialist, the proper diagnosis can be overlooked.
The classic symptoms are dry eyes (xerophthalmia) and dry mouth (xerostomia). Individuals with Sjögren’s syndrome often have blurred vision, constant eye discomfort, recurrent mouth infections, swollen parotid (salivary) glands, hoarseness, and difficulty in swallowing and eating. Dryness of other mucous membranes of the body, such as the intestines, lungs, and reproductive system, may also occur. Extreme fatigue can also seriously alter the quality of life.
Sjögren’s syndrome is most commonly diagnosed in people in their mid-forties. In some individuals, primary Sjögren’s syndrome affects only the tear ducts and salivary glands. In other patients, it is present in conjunction with other diseases such as rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis (scleroderma), or polymyositis/dermatomyositis (secondary Sjögren’s syndrome).
Treatment and Therapy
Once Sjögren’s syndrome is suspected, blood tests for autoantibodies against nuclear or cytoplasmic proteins may be performed. Schirmer’s test, which measures tear production, and salivary scintigraphy, which determines salivary gland function, may also be performed. A lower lip biopsy, to determine the extent of inflammation, may also be needed.
Moisture replacement therapies are designed to ease the symptoms of dryness. The routine use of eyedrops aids in controlling dryness of the eyes, and saliva-stimulating drugs and salivary packets help with difficulties in chewing and swallowing food. For individuals with more severe complications, immunosuppressive or nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed.
Perspective and Prospects
Sjögren’s syndrome is named after the Swedish eye doctor Henrik Sjögren, who first identified the syndrome in 1933. There is no known cure for Sjögren’s syndrome, nor is there a current treatment to restore gland secretion. The outlook for individuals with this condition is usually good because Sjögren’s syndrome is generally not life-threatening.
Bibliography
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"Questions and Answers about Sjögren's Syndrome." National Institute of Arthritis and Musculoskeletal and Skin Diseases. NIH, June 2013. Web. 12 May 2016.
Rose, Noel R., and Ian R. Mackay, eds. The Autoimmune Diseases. 5th ed. San Diego: Academic, 2014. Print.
"Sjogren's Syndrome." Health Library. EBSCO, 9 Nov. 2015. Web. 12 May 2016.
"Sjogren's Syndrome." MedlinePlus, medlineplus.gov/ency/article/000456.htm. Accessed 8 Apr. 2024.
Wallace, Daniel J., et al., eds. The New Sjogren’s Syndrome Handbook. 3rd rev. ed. New York: Oxford UP, 2005. Print.