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Introduction
Sjögren's syndrome is an autoimmune disease characterized
by decreased tears and saliva (the sicca complex). This results
in dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia).
In patients with Sjögren's syndrome the body's own immune system
selectively destroys moisture producing glandular tissue. This process
causes disruption of salivary (saliva producing) and lacrimal (tear
producing) glands leading to decreased saliva and tear production.
What causes Sjögren's syndrome?
The immune system normally defends the body against disease by killing
foreign organisms such as viruses and bacteria by special proteins
called antibodies and cells called lymphocytes. In Sjögren's
and other autoimmune diseases the immune system mistakes the body's
own cells for alien invaders and attacks the body in a process called
autoimmunity. Autoimmunity is characterized by the presence of antibodies
against one's own tissue called autoantibodies. Other autoimmune
rheumatic diseases include rheumatoid arthritis, lupus, scleroderma,
polymyositis and dermatomyositis. Sjögren's syndrome can occur
in association with these other diseases or alone.
Whom does it affect?
Sjögren's syndrome most commonly develops in women between
the ages of 40 and 50 years, but can occur in men and women at any
age. It affects all races.
How is Sjögren's Syndrome diagnosed?
The diagnosis is made on the basis of
Chest x-ray and other laboratory tests to rule out other
causes of symptoms
a history of dry eyes and dry mouth
decreased tear production as indicated by Shirmer's test
which involves using a strip of blotting paper to measure the amount
of tear formation
a biopsy of lip glands confirming the presence of immune
cells in small salivary glands found in the lip
blood test to establish the presence of certain autoantibodies
(Ro/SSA and LA/SSB)
Symptoms of Sjögren's Syndrome
Dry mouth may lead to difficulty in chewing, swallowing, speaking,
abnormalities of taste or smell and cracks in tongue and lips. Tooth
decay and superimposed oral thrush may also occur. People with Sjögren's
frequently carry bottles of water with them and awaken at night
to sip water.
Dryness may also affect nose, throat, voice box, wind pipe and bronchial
tree leading to nose bleeds, hoarseness, ear infection and chest
infection. Patients with Sjögren's Syndrome may have enlarged
parotid glands leading to redness and swelling at the angle of the
jaw.
Other organs affected by Sjögren's Syndrome
Patients with Sjögren's may experience joint pain, swelling
and morning stiffness. Red spots may come and go on patients' legs.
Muscle tenderness and numbness and tingling in the feet may occur.
Patients with Sjögren's are also prone to skin dryness, skin
rashes and allergy.
A small proportion of Sjögren's patients develop enlarged lymph
nodes. Lymphoma (cancer of the lymph nodes) occurs more commonly
in Sjögren's Syndrome than the normal population but fortunately
is relatively rare.
Treatment
While Sjögren's is not curable, much can be done to make the
symptoms manageable.
The thrust of treatment of the dry mouth includes:
medication
prevention and treatment of dental caries
treatment of oral thrush
stimulation of salivary flow (chewing gum)
use of salivary substitutes, mouth rinses or lozenges
avoidance of drugs which dry the mouth
use of moisturizers
avoidance of drying conditions eg drafts from heaters and
air conditioners, eye exposure to sun and wind.
Treatment of dry eyes includes artificial tears and, if severe,
punctum occluson (closure of tear ducts to provide increased volume
of tears by decreasing drainage).
The information presented is not intended to replace the medical
advice of your doctor or health care provider. Arthritis SA recommends
that you consult your doctor about specific medical conditions.
Other information and resources available
from Arthritis SA
Sjögren's Syndrome Fact Sheet
• Email: advisors@arthritissa.org.au
(please include your postal address in email)
Lupus, Scleroderma and Sjögren's SA
Support Group
Click here "Branches & Support
Groups" > "Lupus, Scleroderma, Sjögren's SA"
for further information
Telephone Advisory Service
9.30am - 3.30pm, Mon - Fri
8379 5711 or country free call on 1800 011 041
Library
The Sjögren's Syndrome Survival Guide by Teri Rumpt
and Katherine Hammitt, 2003
Borrowing privileges extend to members only
Booklet Sale
The Sjögren's Question and Answer Booklet
For price and order details please contact Arthritis SA
• 8379 5711 or country free call on 1800 011 041
• Email: info@arthritissa.org.au
(please include your name and business hours phone number in email)
Moving Towards Wellness Course
6 weeks x 2.5 hours
click here "Self Management
Courses" for further information
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