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Sjogren's Syndrome: Causes, Symptoms, Diagnosis And Treatment

Sjogren's syndrome is an autoimmune disorder, which primarily causes dry eyes and dry mouth. The condition is associated with other immune system disorders like lupus, rheumatoid arthritis and primary biliary cholangitis. The prevalence of Sjogren's syndrome worldwide is around 0.1 to 4%.

What Causes Sjogren's Syndrome [1]

Sjogren's syndrome is an auto-immune disorder where your immune system mistakenly attacks the body's cells and tissues. Though the exact cause of this condition is unknown, it is believed that a bacteria or virus infection may trigger the disease and the underlying cause being genetic and environmental factors.

Image source: https://en.wikipedia.org

The immune system first targets the saliva and tear glands, resulting in decreased saliva and tears. It can also damage other body parts as well like the kidneys, liver, joints, lungs, skin, nerves and thyroid glands.

Women are at an increased risk of developing Sjogren's syndrome compared to men [2] .

Doctors have categorized Sjogren's syndrome into primary and secondary. Primary Sjogren's syndrome occurs when you don't have any rheumatic diseases and secondary Sjogren's syndrome occurs when you already have a rheumatic disease.

Symptoms Of Sjogren's Syndrome

  • Burning, itching and grittiness in the eyes
  • Difficulty in chewing and swallowing
  • Joint pain
  • Skin rashes
  • Swollen salivary glands
  • Persistent dry cough
  • Vaginal dryness
  • Fatigue
  • Speaking difficulty
  • Blurred vision
  • Muscle ache
  • Lung disease
  • Peripheral neuropathy

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Risk Factors Of Sjogren's Syndrome [3]

  • Sex - Women are more likely to have this condition.
  • Age - People older than 40 is usually diagnosed with Sjogren's syndrome.
  • Rheumatic disease - People who have this condition also have a rheumatic disease.

Complications Of Sjogren's Syndrome [4]

  • Vision problems
  • Dental cavities
  • Yeast infections
  • Inflammation in the lungs, kidney or liver
  • An increased risk of lymphoma and multiple myeloma
  • Peripheral neuropathy

Diagnosis Of Sjogren's Syndrome [5]

This condition can be difficult to diagnose because the symptoms are similar to those caused by other diseases. Certain tests can help in diagnosing this condition, these include:

  • Blood tests - It is done to check the levels of different types of blood cells, the presence of antibodies common in Sjogren's syndrome and other inflammatory conditions.
  • Eye tests - Schirmer tear test is done to check the dryness of your eyes by placing a small piece of filter paper under your lower eyelid to measure your tear production.
  • Saliva tests - It evaluates the function of the salivary glands. If the saliva production is insufficient, it may indicate Sjogren's syndrome.
  • Imaging tests - Imaging tests like sialogram and salivary scintigraphy are done to check the function of the salivary glands.
  • Biopsy - Lip biopsy is used to detect if there are any clusters of inflammation on the lips. It is done by removing a small tissue from the salivary glands in your lips and examined under a microscope.

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Treatment Of Sjogren's Syndrome [5]

Medications

To decrease inflammation of the eyes, eye drops are prescribed to treat moderate to severe dry eyes. Also to increase the production of saliva medications such as pilocarpine and cevimeline are prescribed by the doctor.

Disease-modifying antirheumatic drugs (DMARDs) and anti-fungal medications are used for relieving the symptoms of joint pain and oral yeast infections respectively.

Surgery

Punctual occlusion is a surgery option, wherein the tear ducts are sealed with small plugs to reduce the drainage of tears from the eyes. This helps retain the eye's moisture for a longer period.

View Article References
  1. [1] Fisher, B. A., Jonsson, R., Daniels, T., Bombardieri, M., Brown, R. M., Morgan, P., ... & Shirlaw, P. (2017). Standardisation of labial salivary gland histopathology in clinical trials in primary Sjögren's syndrome.Annals of the rheumatic diseases,76(7), 1161-1168.
  2. [2] Ramírez Sepúlveda, J. I., Kvarnström, M., Eriksson, P., Mandl, T., Norheim, K. B., Johnsen, S. J., … Wahren-Herlenius, M. (2017). Long-term follow-up in primary Sjögren's syndrome reveals differences in clinical presentation between female and male patients.Biology of sex differences,8(1), 25.
  3. [3] Priori, R., Medda, E., Conti, F., Cassara, E. A. M., Sabbadini, M. G., Antonioli, C. M., ... & Valesini, G. (2007). Risk factors for Sjögrenʼs syndrome: a case-control study.Clinical and experimental rheumatology,25, 378-384.
  4. [4] Brito-Zerón, P., & Ramos-Casals, M. (2014). Advances in the understanding and treatment of systemic complications in Sjögren's syndrome.Current opinion in rheumatology,26(5), 520-527.
  5. [5] Stefanski, A. L., Tomiak, C., Pleyer, U., Dietrich, T., Burmester, G. R., & Dörner, T. (2017). The Diagnosis and Treatment of Sjögren's Syndrome.Deutsches Arzteblatt international,114(20), 354–361.

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