Paediatric Rheumatology

Sjogren’s Syndrome

Introduction to Sjogren’s Syndrome

Sjögren’s syndrome is a condition where the body’s immune systems wrongly attacks its own glands. This results in inflammation and damage to the secretory glands.

Written by Doctify Team 27/04/2020

What is Sjögren’s Syndrome?

Sjögren’s syndrome is a condition where the body’s immune systems wrongly attacks its own glands. This results in inflammation and damage to the secretory glands responsible for producing tears and saliva and other fluids and therefore causes symptoms such as dry eyes and a dry mouth. It is known as an autoimmune disorder and the effects can be widespread; as well as affecting glands throughout the body, there are also extraglandular symptoms that can arise from Sjögren’s syndrome. Sjögren’s mostly affects middle to older aged women (90%).

What are the causes for Sjögren’s Syndrome?

Sjögren’s syndrome is an autoimmune condition caused by the body attacking itself and in particular, attack the secretory glands around the body. The effects of this syndrome can be widespread (extraglandular manifestations of Sjögren’s syndrome). Primary Sjögren’s is thought to be brought on by a combination of environmental and genetic factors. The genetic factors make certain individuals susceptible to specific environmental triggers (e.g. a virus). Secondary Sjögren’s syndrome is where the condition is associated with other autoimmune conditions (e.g. lupus).

What are the symptoms of Sjögren’s Syndrome?

The commonest symptoms include dry eyes and a dry mouth. In women, vaginal dryness is also common. It is common to have dry eyes and a dry mouth in old age and it is only Sjögren’s when confirmed by investigations. Dry mouth can lead to decay and disease of the teeth and gums, cause a dry cough, dysphagia (trouble swallowing), vocal changes, dysarthria (trouble speaking) and swelling of the salivary glands that are located near the jaw and ears. Having a dry mouth can also lead to fungal infections such as oral thrush. Dry eyes can also cause itching, stinging, eyelid tenderness, photophobia and mucus discharge. Depending on the severity of Sjögren’s, there can be extraglandular manifestations which can cause skin dryness, muscles and joint pain, blood vessel inflammation, gastrointestinal problems (e.g. reflux, hepatitis), neurological problems (e.g. depression) and respiratory problems (e.g. chronic bronchitis).

How is Sjögren’s Syndrome treated?

There is no cure for Sjögren’s syndrome but the symptoms can usually be well managed. Artificial tears can help moderate eye dryness and steroid eye drops can help any flare-up of inflammation or irritation. There are other options such as moisture chamber glasses which Doctors can recommend depending on the severity of the eye dryness.
Mouth dryness can be managed by regularly lubricating the mouth and preventing the manifestations of having a dry mouth (e.g. having good oral hygiene and drinking plenty of fluids). A medication called Pilocarpine is commonly prescribed as it can encourage glands to produce more tears and saliva. Certain other medications act on the immune system to slow and reduce the attack on the salivary glands (e.g. hydroxychloroquine). Other manifestations can be managed if they arise.

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