Sjogren's Syndrome

What is Sjogren's syndrome?

From: MedlinePlus, National Library of Medicine

Sjogren's syndrome, also called Sjogren's disease, is a chronic (long-lasting) autoimmune disease. When you have an autoimmune disease, your immune system attacks healthy tissues and organs by mistake. In Sjogren's syndrome, your immune system attacks the glands that make moisture in the eyes, mouth, and other parts of the body. This causes a dry mouth and dry eyes. You may have dryness in other places that need moisture, such as your nose, throat, and skin. Sjogren's can also affect other parts of the body, including your joints, lungs, kidneys, blood vessels, digestive organs, and nerves.

What causes Sjogren's syndrome?

From: MedlinePlus, National Library of Medicine

Normally, your immune system protects the body from infection and disease. But with Sjogren's syndrome and other autoimmune diseases, your immune system attacks healthy tissues and organs. Researchers don't know for sure what causes the immune system to do this. But they think that it is caused by a combination of genetic and environmental factors. Studies have linked Sjogren's syndrome to gene changes in several genes. Some researchers also think that the disease may be triggered by something in the environment. For example, they think that one possible trigger could be a previous infection with a virus or bacteria.

Who is more likely to develop Sjogren's syndrome?

From: MedlinePlus, National Library of Medicine

Most people with Sjogren's syndrome are women. You can get it at any age, but it is most common in people in their 40s and 50s.

Sjogren's syndrome is more common in people who have other autoimmune diseases such as rheumatoid arthritis and lupus. This is known as a secondary form of Sjogren's syndrome. People who don't have another autoimmune disease have a primary form of Sjogren's syndrome.

What are the symptoms of Sjogren's syndrome?

From: MedlinePlus, National Library of Medicine

Sjogren's syndrome may have different effects on the body. Not everyone will have the same symptoms. Some people have cycles of mild and then severe symptoms.

The two main symptoms are:

Sjogren's syndrome can also affect other parts of the body, causing symptoms such as:

• Dry eyes. Your eyes may burn or itch or feel like they have sand in them. Sometimes your vision may be blurry, or you could be bothered by bright lights.
• Dry mouth. Your tongue and your throat may feel dry. You might have trouble swallowing, speaking, and tasting.
• Joint and muscle pain
• Dry skin
• Rashes on the skin of hands or feet
• Numbness or tingling in the hands or feet
• Vaginal dryness
• Dry cough that doesn't go away
• Fatigue that doesn't go away

How is Sjogren's syndrome diagnosed?

From: MedlinePlus, National Library of Medicine

There is no single test for Sjogren's syndrome. To find out if you have it, your provider:

• Will ask about your medical history and symptoms.
• Will do a physical exam, which includes checking for signs of dry mouth and signs of related autoimmune diseases.
• May order tests, including: Eye tests to see if you produce a normal amount of tears and to find out if your eyes have been damaged by dryness. Salivary gland tests to measure how much saliva your mouth produces. They could include imaging tests and a biopsy. Blood tests.

What are the treatments for Sjogren's syndrome?

From: MedlinePlus, National Library of Medicine

There is no cure for Sjogren's syndrome. Treatment focuses on relieving your symptoms. The treatments can be different for each person, depending on which parts of the body are affected. They may include:

• Eye drops (artificial tears) or ointments to relieve dryness in the eyes.
• Saliva substitutes.
• Prescription medicines that cause your salivary glands to make more saliva.
• A minor procedure that places small plugs in the tear duct in the corners of the eyes. The plugs block your tears from draining so they stay in your eyes longer.
• Medicines to help with other symptoms caused by Sjogren's syndrome, such as medicines for pain and inflammation.
• Medicines that suppress (weaken) your immune system (for severe cases).

You can also try to relieve some of your symptoms by sucking on sugar-free candy, drinking water often, increasing the humidity in your room, and not smoking. Because having a dry mouth can raise your risk of cavities, it's important to take good care of your teeth and see your dentist regularly.

Which doctor should you see?

The suggested department for discussing Sjogren's Syndrome is Rheumatology, with a rheumatologist as the relevant type of clinician. General physician / Family Medicine; paediatrician for children. Referral depends on symptoms.

Additional services that may be relevant, depending on the findings, include: Clinical Genetics.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• Are the findings inflammatory, structural or due to another mechanism?
• Is there evidence that other organs need assessment?
• How will function and any treatment-related risks be monitored?

Treatment discussions and follow-up

Where the source describes treatments, these are an overview of possible care, not a prescription for an individual. Ask which option applies to the confirmed diagnosis, what benefit is expected, what adverse effects to watch for and how progress will be assessed. Availability, approvals and local practice can differ from the country described in the source.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

The collected references do not establish a complete prevention or long-term outlook section for this entry. Missing information should not be interpreted as proof that prevention is impossible or that a particular outcome is inevitable. Ask what is known for the exact subtype, stage and personal circumstances, and which uncertainties remain.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.