Sjogren's Syndrome

What is Sjogren's syndrome?

Sjogren's syndrome is an autoimmune disorder. This means that your body's defenses against infection are attacking your own tissue. When you have Sjogren's syndrome, the immune cells attack and destroy the glands that produce tears and saliva. Damage to these glands keeps them from working properly and causes dry eyes and dry mouth. Other parts of the body, such as the kidneys, blood vessels, and nervous system can also be affected.

How does it occur?

The cause of Sjogren's syndrome is not known. It may be inherited. Viral or bacterial infections may also play a role in its development.

The disease occurs most often in women between ages 40 and 65. It may occur as a single disorder or you may have it along with other inflammatory diseases such as lupus, rheumatoid arthritis, scleroderma, or polymyositis.

What are the symptoms?

Sjogren's syndrome may cause:

• dry eyes and mouth
• pain in the eyes or the feeling that a piece of sand is in the eyes
• trouble chewing and swallowing
• sore mouth
• tooth decay
• swollen salivary glands
• vaginal dryness
• dryness of the upper respiratory system, causing nosebleeds, hoarseness, dry cough, or infections of the sinuses or lungs
• dry skin
• fatigue.

How is it diagnosed?

Your health care provider will ask about your symptoms and examine you. You may have tests such as:

• Salivary gland biopsy of the lip. Your provider removes tiny minor salivary glands from the inside of the lower lip and examines them under the microscope. This test is the best way to find out whether dry mouth is caused by Sjogren's syndrome.
• Eye exams to measure how well your tear glands produce tears, how dry your eyes are, and whether the outside of your eye is inflamed.
• Mouth exams to see if the salivary glands are swollen. You may have a saliva test to see how much saliva the glands are producing and to check its quality.

You may also have blood tests, urine tests, and chest x-rays.

How is it treated?

There is no known cure, but treatment can help the symptoms. Treatment is different for each person, depending on what parts of the body are affected. To relieve dry eyes or dry mouth, your provider may recommend:

• using artificial-tears eyedrops during the day and artificial-tears ointment at night
• using artificial saliva
• chewing sugarless gum
• drinking more fluids.

When Sjogren's affects other parts of your body as well as your glands, your provider may recommend or prescribe:

• a vaginal lubricant, such as K-Y jelly, for vaginal dryness
• nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin, for pain or discomfort.

In more severe cases, especially if other organs such as the kidneys are involved, treatment may include:

• steroids (prednisone)
• drugs that suppress the immune system, such as hydroxychloroquine, methotrexate, and cyclophosphamide.

How long will the effects last?

The effects of Sjogren's are different from person to person. The symptoms may vary with time, being sometimes better and sometimes worse. Treatment may help some people more than others. Sjogren's is a serious disease but most people with the condition have a normal lifespan.

How can I help take care of myself?

• Follow your health care provider's plan for treatment.
• Discuss all medicines you are taking with your health care provider. Drugs that can cause dryness include antihistamines, decongestants, and high blood pressure medicines.
• Visit a dentist at least 3 times a year to have your teeth examined and cleaned.
• Rinse your mouth with water several times a day. Don't use mouthwash that contains alcohol because alcohol is drying.
• Put a humidifier in the rooms where you spend the most time.
• Do not smoke. Avoid smoky rooms.
• See your health care provider promptly if you have new symptoms.

For more information, call the Sjogren's Syndrome Foundation at 800- 475-6473 or visit their web site at http://www.sjogrens.org.