Sjogren syndrome?
DefinitionSjogren syndrome is an autoimmune disorder in which the glands that produce tears and saliva are destroyed. The condition may affect many different parts of the body, including the kidneys and lungs.Alternative NamesXerostomia-Sjogren syndrome; Keratoconjunctivitis sicca-Sjogren'sCauses, incidence, and risk factorsThe cause of Sjogren syndrome is unknown. The syndrome occurs most often in women ages 40 - 50. It is rare in children. Young patients usually have signs of another autoimmune disorderfirst.The syndrome may be associated with:PolymyositisRheumatoid arthritisSclerodermaSystemic lupus erythematosusSjogren syndrome affects about 1 - 4 million people in the United States.SymptomsDryness of the mouth and eyes are the most common symptoms of this syndrome.Eye symptoms:Itching eyesFeeling that something is in the eyeMouth and throat symptoms:Difficulty swallowing or eatingLoss of sense of tasteDifficulty speakingThick or stringy salivaMouth sores or painHoarsenessOther symptoms may include:FatigueFeverChange in the color of hands or feetJoint pain or joint swellingSwollen glandsSigns and testsA physical examination reveals dry eyes and mouth. There may be mouth sores because of the mouth dryness.Tests:Schirmer's testAntinuclear antibodies (ANA) testSalivary gland biopsyRheumatoid factor (possible)Tear testSlit lamp examination with rose bengal dyeTreatmentThe goal is to relieve symptoms. Dry eyes may be treated with artificial tears, eye-lubricating ointments, or cyclosoporine liquid. Tiny plugs can be placed in the tear drainage ducts to help the tears stay on the surface of the eye.Disease modifying drugs (DMARDs) similar to those used for rheumatoid arthritis may improve the symptoms of Sjogren syndrome. These include tumor necrosis factor (TNF) inhibiting drugs.Sipping water throughout the day and chewing sugarless gum may help relieve mouth dryness. Avoid medicines that can cause mouth dryness such as antihistamines and decongestants. Avoid alcohol.Talk with your dentist about:Solutions to replace minerals in your teethSaliva substitutesDrugs that help your salivary glands make more salivaFrequent brushing and flossing of the teeth, and regular dental visits may prevent severe dental cavities caused by dry mouth.Arthritissymptoms are commonly treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy.Expectations (prognosis)The disease is usually not life-threatening. The outcome depends on what other diseases you have.There is an increased risk of lymphoma.ComplicationsKidney failure(rare)LymphomaPulmonary infectionVasculitis (rare)Calling your health care providerCall for an appointment with your health care provider if you develop symptoms of Sjogren syndrome.ReferencesKruszka P, O'Brian RJ. Diagnosis and management of Sjogren syndrome. Am Fam Physician. 2009;79:465-470.Taubert M, Davies MR, Black I. Dry Mouth. BMJ. 2007;334:534.
