The autoimmune condition Sjogren’s syndrome affects the body’s moisture production capabilities, causing dryness in the eyes, mouth, and other body areas. It impairs the functioning of salivary and tear glands, creating discomfort during eating and speaking. Additionally, diagnosing Sjogren’s syndrome becomes difficult in cases where the patient also suffers from lupus or rheumatoid arthritis. 

Thus, whether you are an individual looking to broaden your knowledge, a NEET PG aspirant or a healthcare professional, knowing in detail about Sjogren’s syndrome is crucial. It will help facilitate early diagnosis, which can lead to better treatment outcomes. 

This article covers Sjögren’s syndrome symptoms, causes, treatment options and other crucial aspects.    

What is Sjogren’s Syndrome?

Sjogren’s syndrome is an autoimmune condition in which the immune system mistakenly attacks healthy cells instead of fighting infections. Following is a detailed overview:

• White blood cells, which usually protect the body from germs, target the glands responsible for producing moisture. 
• As a result, these glands struggle to make tears and saliva, leading to dryness in the eyes, mouth, and other areas. 
• While, as of now, there is no cure, various treatments can help manage the symptoms and provide relief.

Being diagnosed with Sjogren’s syndrome can feel overwhelming, but most people with this autoimmune disorder remain in good health and do not experience severe complications. With proper care, you can continue your daily activities without needing to make major lifestyle changes.

What are the Types of Sjogren’s Syndrome?

Doctors classify Sjogren’s syndrome into two main types based on whether it occurs alone or alongside other autoimmune conditions:

1. Primary Sjogren’s Syndrome

This form develops on its own without being linked to any other autoimmune or rheumatic disease.

2. Secondary Sjogren’s Syndrome

In this case, the condition appears along with another autoimmune disorder such as lupus, scleroderma, or rheumatoid arthritis.

What are the Causes of Sjogren’s Syndrome? 

The following are the main causes of Sjogren’s syndrome:

• Genetic Factors

Sjogren’s syndrome is thought to have a strong genetic component. Some individuals inherit a specific gene that causes their white blood cells to mistakenly attack healthy cells instead of fighting infections. 

This malfunction leads to the disease’s autoimmune nature. Although the condition runs in families, there is no definitive explanation for why some people develop it while others do not.

• Infection Caused by a Virus or Bacteria

Certain bacterial or viral infections may activate the immune system in a way that triggers Sjogren’s syndrome. In individuals with a genetic predisposition, the immune system may become overactive while fighting off an infection. 

Thus, instead of targeting only harmful bacteria or viruses, the immune cells mistakenly attack healthy tissues, especially the salivary and tear glands, causing inflammation and dryness.

What are the Risk Factors of Sjogren’s Syndrome? 

Several factors may increase the likelihood of developing Sjogren’s disease. These are as follows:

• Age

People who exceed age 40 face elevated chances of developing Sjogren’s syndrome.

• Gender

The prevalence of Sjogren’s syndrome runs higher among female patients as opposed to male patients.

• Rheumatic Conditions

People who have Sjogren’s syndrome symptoms generally tend to have one or multiple rheumatic conditions.

What are the Symptoms of Sjogren’s Syndrome? 

The following are the Sjögren’s syndrome symptoms:

• Itchy or dry eyes
• Dry mouth, thick saliva, or mouth sores
• Vaginal dryness
• Dry or flaky skin
• Nasal dryness, sometimes leading to frequent nosebleeds
• Persistent dry throat, often causing frequent coughing

Apart from dryness, Sjogren’s syndrome can also lead to:

• Joint stiffness or pain
• Muscle weakness or aches
• Swollen lymph nodes
• Constant fatigue or low energy
• Increased sensitivity to light
• Trouble concentrating 
• Difficulty in speaking or swallowing 
• Changes in taste perception
• Skin rashes or irritation
• Nerve-related issues (neuropathy)
• Digestive discomfort, such as heartburn
• Increased sensitivity to light
• Tooth decay or tooth loss

How is Sjogren’s Syndrome Diagnosed?

Identifying Sjogren’s syndrome can be difficult since its symptoms vary from person to person and often resemble other medical conditions. However, several tests can help confirm the diagnosis and rule out other possible health issues.

1. Blood Tests

Healthcare professionals conduct blood tests to determine Sjogren’s syndrome status by examining its tissue-related effects. These tests can help detect:

• Inflammation markers like elevated ESR (erythrocyte sedimentation rate) or CRP (C-reactive protein).
• Abnormal levels of kidney and liver function suggest the disease affects body organs.
• The existence of particular antibodies at elevated levels indicates an autoimmune condition.
• Changes in blood cell counts, such as abnormal levels of white and red blood cells.

2. Eye Tests

Your doctor may conduct eye tests to assess tear production and check for eye damage caused by dryness.

• Slit-lamp Test: If your eyes are too dry, your cornea may become damaged. Sjogren’s syndrome specialists may use special eye drops and examine your cornea under a magnifying device called a slit lamp.
• Schirmer Tear Test: This test measures tear production by placing a small strip of filter paper under your lower eyelid. The paper absorbs tears, helping to determine if your eyes are producing enough moisture.

3. Imaging Tests

Imaging procedures help assess the saliva flow in your mouth through two methods:

• Sialogram: A dye is injected into your salivary glands near your ears to track how saliva moves through your mouth.
• Salivary Scintigraphy: A radioactive substance is injected into your vein, and its movement through your salivary glands is monitored over an hour to evaluate saliva production.

4. Lip Biopsy

Sjogren’s syndrome causes inflammation in the salivary glands inside your lip. If needed, your doctor may remove a small tissue sample from your lip and examine it under a microscope to look for clusters of inflamed cells.

What are the Complications of Sjogren’s Syndrome?

Sjögren’s syndrome can lead to complications, particularly when the immune system mistakenly attacks other organs and tissues. These may include:

• A higher risk of developing lymphoma or, in rare cases, multiple myeloma
• Neurological problems affecting the brain, spine, or nerves, leading to numbness or muscle weakness
• Oral yeast infections
• Increased susceptibility to dental cavities
• Vision issues due to prolonged dryness
• Inflammation that can result in bronchitis, pneumonia, or other lung conditions
• Impaired liver or kidney function
• Autoimmune-related liver diseases such as cirrhosis or autoimmune hepatitis
• Interstitial cystitis, leading to bladder discomfort

However, most individuals with Sjögren’s syndrome do not face severe complications. Those with secondary Sjögren’s syndrome may have a greater likelihood of complications due to the underlying condition causing it.

What are the Treatment Options for Sjogren’s Syndrome?

Here are some treatment options for Sjogren’s syndrome that you may consider:

• Artificial Tears

Over-the-counter (OTC) artificial tears can provide eye lubrication. Prescription alternatives, such as hydroxypropyl cellulose pellets and cyclosporine ophthalmic emulsion, can reduce reliance on artificial tears.

• Prescription Expectorants and Throat Treatments

If you experience respiratory dryness, medications that stimulate saliva flow, along with ingredients like linseed extract, sorbitol, xylitol, or malic acid, can provide relief.

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Pain relievers such as aspirin, naproxen, and ibuprofen can help if you have joint pain.

• Disease-modifying Antirheumatic Drugs (DMARDs)

If joint pain is accompanied by fatigue or rashes, medications like hydroxychloroquine or methotrexate may help. In severe cases affecting nerves, muscles, kidneys or lungs, healthcare providers may prescribe stronger DMARDs, corticosteroids, or rituximab.

• Dry Eye Surgery (Punctal Plugs)

An ophthalmologist may perform a procedure to partially or fully close your tear ducts, helping your natural tears stay in your eyes longer.

• Special Mouthwash and Dental Products

Since Sjogren’s syndrome increases the risk of dental problems, you may require regular cleanings, fluoride treatments, or prescription toothpaste and mouthwash to maintain oral health.

• Saliva Stimulants

Your dentist might recommend OTC saliva substitutes or prescription medications to enhance saliva production. They may also advise chewing gum, sipping water frequently, or sucking on ice chips to keep your mouth hydrated.

• Vaginal Moisturisers and Lubricants

Your healthcare provider may suggest OTC or prescription lubricants to keep the vaginal area moisturised, either for daily use or during intercourse.

• Hormone Therapy

If vaginal dryness is linked to a hormonal imbalance, supplemental estrogen or other hormone treatments may be recommended.

FAQs About Sjogren’s Syndrome 

1. What is Sjogren’s syndrome?

Sjogren’s syndrome is an autoimmune disorder where the immune system attacks the glands that produce moisture, causing dryness in the eyes, mouth, and other areas.

2. How does Sjogren’s syndrome affect life expectancy?

Most people with Sjogren’s syndrome have a normal life expectancy. However, those with secondary Sjogren’s syndrome may face complications that can impact their health over time. In rare cases, individuals with this condition develop lymphoma, a type of blood cancer which can affect overall survival.

3. How does Sjogren’s disease affect the skin?

Sjogren’s disease can lead to dry, flaky skin and may cause rashes.

4. What are the risks of leaving Sjogren’s disease untreated?

Without treatment, Sjogren’s disease can reduce the quality of life and lead to complications such as: 

• Dental issues 
• Nerve problems 
• Eye ulcers 
• Frequent nosebleeds 
• Swollen salivary glands 
• Swallowing difficulties 
• Acid reflux 
• Slow digestion 
• Bowel discomfort 
• Kidney-related symptoms

5. How is Sjogren’s syndrome treated?

Treatment includes artificial tears, saliva stimulants, NSAIDs for joint pain, DMARDs, hormone therapy, and, in some cases, minor surgical procedures.

Conclusion

Knowing Sjogren’s syndrome is essential for effective diagnosis and management. This autoimmune disorder affects moisture-producing glands, leading to dryness in various parts of the body. Early identification through blood tests, imaging, and biopsies helps in timely intervention. While there is no cure currently, treatments like artificial tears, DMARDs, and saliva stimulants can significantly improve quality of life.

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