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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.
A.D.A.M. Medical Encyclopedia.
Sjogren syndrome is an autoimmune disorder in which the glands that produce tears and saliva are destroyed, causing dry mouth and dry eyes. However, the condition may affect many different parts of the body, including the kidneys and lungs.
Causes, incidence, and risk factors
The cause of Sjogren syndrome is unknown. It is an autoimmune disorder, which means the body mistakenly attacks healthy tissue. The syndrome occurs most often in women ages 40 - 50. It is rare in children.
Primary Sjogren syndrome is defined as dry eyes and dry mouth without another autoimmune disorder.
Secondary Sjogren syndrome occurs alone with another autoimmune disorder, such as:
Sjogren syndrome affects about 1 - 4 million people in the United States.
Symptoms
Dryness of the mouth and eyes are the most common symptoms of this syndrome.
Eye symptoms:
- Feeling that something is in the eye
Mouth and throat symptoms:
- Difficulty swallowing or eating
- Difficulty speaking
- Thick or stringy saliva
- Mouth sores or pain
Other symptoms may include:
- Fever
- Change in the color of hands or feet
Signs and tests
A physical examination reveals dry eyes and mouth. There may be mouth sores because of the mouth dryness.
Tests:
- Schirmer's test of tear production
- Antinuclear antibodies (ANA) test
- Rheumatoid factor (possible)
- Slit lamp examination of the eyes
Treatment
The 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 teeth
- Saliva substitutes
- Drugs that help your salivary glands make more saliva
Frequent brushing and flossing of the teeth, and regular dental visits may prevent severe dental cavities caused by dry mouth.
Arthritis symptoms 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.
Complications
- Kidney failure (rare)
- Lymphoma
- Pulmonary infection
- Vasculitis (rare)
Calling your health care provider
Call for an appointment with your health care provider if you develop symptoms of Sjogren syndrome.
References
- Kruszka P, O'Brian RJ. Diagnosis and management of Sjogren syndrome. Am Fam Physician. 2009;79:465-470. [PubMed: 19323359]
- Wu AJ. Optimizing dry mouth treatment for individuals with Sjögren's syndrome. Rheum Dis Clin North Am. 2008 Nov;34(4):1001-10, x. [PubMed: 18984418]
Review Date: 6/28/2011.
Reviewed by: Ariel D. Teitel, M.D., M.B.A., Chief, Division of Rheumatology, St. Vincent’s Hospital, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Interventions for the management of dry mouth: topical therapies
Dry mouth is a common problem with a range of causes. The symptom may be due to a reduction in the quantity of saliva produced, or a change in the composition of saliva, but a feeling of dry mouth may also be present in people with normal saliva production. Radiotherapy or chemotherapy for head and neck cancers, and diseases such as Sjögren's Syndrome, may result in reduced saliva production. Many commonly prescribed medications are associated with a feeling of dry mouth, despite normal saliva production. As well as difficulty in speaking, chewing and swallowing, prolonged dry mouth may result in increased risk of tooth decay and reduced quality of life. In many sufferers dry mouth cannot be cured, but effective ways for people to manage dry mouth symptoms are available. Many topical treatments (applied directly to the inside of the mouth) such as sprays, lozenges, mouthrinses, gels, oils, chewing gum or toothpastes have been evaluated in this review, but there is no strong evidence that any topical treatment is effective for relieving the sensation of dry mouth. Oxygenated glycerol triester (OGT) saliva substitute spray is more effective than a water based electrolyte spray. A gel‐releasing device worn in the mouth, or a mouthcare system might be effective but more research is needed. Chewing gum increases saliva production but there is no evidence that gum is better or worse than saliva substitutes. Acidic products and those containing sugar should be avoided.
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