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Sjögren's Syndrome

Sjögren's syndrome is an autoimmune disease that attacks moisture-producing glands, causing dry eyes and dry mouth, and can also affect the joints, skin, nerves, and internal organs.

Immunology
Sjögren's syndrome is a chronic autoimmune disease in which the immune system attacks the glands that make tears and saliva, leading to the hallmark symptoms of dry eyes and dry mouth. It can occur on its own (primary Sjögren's) or alongside another autoimmune disease such as rheumatoid arthritis or lupus (secondary Sjögren's). The condition affects women far more often than men — roughly nine out of ten patients are women — and most people are diagnosed after age 40. Although dryness is the defining feature, fatigue and joint aches are often the symptoms that interfere most with daily life.

Causes

The cause is not fully understood. As in other autoimmune diseases, inherited susceptibility genes appear to combine with environmental triggers, possibly including viral infections, to set off an immune attack — in this case on the lacrimal (tear) and salivary glands. White blood cells infiltrate the glands and gradually reduce their output, and the same process can involve organs beyond the glands.

Symptoms

Dryness is the core problem, but Sjögren's is a systemic disease:
  • Dry, gritty eyes: Burning, itching, a foreign-body sensation, and sensitivity to light; severe dryness can damage the cornea.
  • Dry mouth: Difficulty chewing and swallowing dry food, altered taste, a burning tongue, and needing water constantly.
  • Dental problems: Saliva protects teeth, so cavities, gum disease, and oral yeast infections become much more common.
  • Salivary gland swelling: The parotid glands in front of the ears may swell, sometimes repeatedly.
  • Joint and muscle pain: Aching and stiffness resembling mild inflammatory arthritis are common, as is significant fatigue.
  • Other involvement: Dry skin, vaginal dryness, chronic cough, nerve symptoms such as numbness or tingling, and, less commonly, kidney, lung, or liver inflammation.
Autoimmune thyroid disease, particularly hypothyroidism, occurs more often in people with Sjögren's, so thyroid testing is frequently part of care. A small proportion of patients — the disease's most important long-term risk — eventually develop lymphoma of the glands or lymph nodes, which is why persistent, firm gland swelling always deserves evaluation.

Diagnosis

Diagnosis combines symptoms with objective testing. Because dryness has many everyday causes — medications such as antihistamines and decongestants are among the most common — the evaluation also focuses on excluding these. Blood tests look for anti-SSA (Ro) and anti-SSB (La) antibodies, antinuclear antibodies, and rheumatoid factor. Eye tests measure tear production and check the eye surface for dryness damage, and dental or imaging studies can assess salivary flow. When the picture remains unclear, a small biopsy of minor salivary glands from the inner lip can confirm the characteristic immune infiltration.

Treatment

There is no cure, but treatment relieves symptoms and protects the eyes, teeth, and organs:
  • Eye care: Preservative-free artificial tears through the day, lubricating gels at night, prescription anti-inflammatory eye drops, and tiny plugs that slow tear drainage.
  • Mouth care: Frequent sips of water, sugar-free gum or lozenges to stimulate saliva, prescription medicines that boost saliva production, and meticulous dental hygiene with regular dental visits and fluoride.
  • Systemic treatment: Hydroxychloroquine is often used for joint pain, rashes, and fatigue; stronger immunosuppressants are reserved for significant organ involvement.
  • Practical measures: A bedroom humidifier, avoiding drying medications when possible, and not smoking all reduce daily symptoms.
Sjögren's is a lifelong condition that rewards steady, coordinated care. The internal-medicine team at Zimmer Medical Group can evaluate persistent dryness, order the right tests, and coordinate rheumatology, eye, and dental care — schedule a visit if dry eyes and dry mouth have become part of your daily life.

Related Medications

Commonly prescribed medications for this condition

Hydroxychloroquine

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