Sjögren's Syndrome: Causes, Symptoms, Diagnosis ...

Sjögren's syndrome is a lifelong autoimmune disorder that reduces the amount of moisture produced by glands in the eyes and mouth. ComingtoaClevelandCliniclocation?Visitation,maskrequirementsandCOVID-19information Home / HealthLibrary / Disease&Conditions Sjögren'sSyndrome Sjögren’ssyndromeisachronicdisorderthatcausesinsufficientmoistureproductionincertainglandsofthebody,includingthesaliva-producingandtear-producingglands.Thelungs,bowelandotherorgansarelessoftenaffectedbySjögren’ssyndrome. Appointments&Access ContactUs Overview SymptomsandCauses DiagnosisandTests ManagementandTreatment Prevention Outlook/Prognosis LivingWith Sjögren'sSyndrome Overview SymptomsandCauses DiagnosisandTests ManagementandTreatment Prevention Outlook/Prognosis LivingWith BackToTop Overview WhatisSjögren'ssyndrome? Sjögren'ssyndromeisalifelongautoimmunedisorderthatreducestheamountofmoistureproducedbyglandsintheeyesandmouth.ItisnamedforHenrikSjögren,aSwedisheyedoctorwhofirstdescribedthecondition.Whiledrymouthanddryeyesaretheprimarysymptoms,mostpeoplewhohavetheseproblemsdon'thaveSjögren'ssyndrome.Drymouthisalsocalledxerostomia. TherearetwoformsofSjögren'ssyndrome: PrimarySjögren'ssyndromedevelopsonitsown,notbecauseofanyotherhealthcondition. SecondarySjögren'ssyndromedevelopsinadditiontootherautoimmunediseaseslikerheumatoidarthritis,lupusandpsoriaticarthritis. WhomightgetSjögren'ssyndrome? AnestimatedonetofourmillionAmericanshaveSjögren'ssyndrome.Thediseaseaffectspeopleofallraces,ethnicitiesandages.However,womenareninetimesmorelikelytodevelopthisconditionthanmen. SymptomsandCauses WhatcausesSjögren’ssyndrome? Sjögren’ssyndromeisanautoimmunedisease,whichmeanssomethingtriggersyourimmunesystemtoattackhealthycells.Thisattackdamagesthetearsysteminyoureyesandthesalivaryglandsinyourmouth. Exactlywhatcausesthisabnormalimmunesystemresponseisnotclear.Thesefactorsmayplayarole: Environmentalfactors. Genetics. Sexhormones(theconditionaffectsmorewomenthanmen). Viralinfections. WhatarethesymptomsofSjögren’ssyndrome? Inadditiontoextremelydryeyesandmouth,somepeopleexperiencemusclepainandjointpainalloverthebody,similartofibromyalgia.Othersymptomsinclude: Abnormalsenseoftaste. Burningorrednessineyes,orgrittiness(likesand). Blurryvision. Difficultychewing,swallowingortalking. Drycoughorhoarseness. Dry,itchyskin. Enlargedsalivaryglands. Fatigue. Toothdecayorearlytoothloss. Vaginaldryness. DiagnosisandTests HowisSjögren’ssyndromediagnosed? Ifyouhavedrymouth,dryeyesorothersignsofSjögren’ssyndrome,yourdoctormayusethesemethodstoconfirmadiagnosis: Bloodtests:Thesetestsdetectspecificantibodiesintheblood.Theylookforanti-nuclearantibodies(ANA),anti-Sjögren’ssyndromeantibodies(anti-SSA,alsocalledanti-Ro)andanti-Sjögren’ssyndrometypeB(anti-SSB,alsocalledanti-La).Abloodtestcanalsodetectrheumatoidfactor,anantibodyfoundinmanypeoplewhohaverheumatoidarthritis. Biopsy:Yourdoctormayremovetissueorcellsfromasalivaryglandortheinsideofyourlip.Thisbiopsysamplegoestoalabtocheckforsignsofinflammation. Eyeexam:Aneyespecialist,suchasanophthalmologist,canmeasuretearproduction.Duringaneyeexam,yourdoctorwillexaminethecornea,theclearpartoftheeye,fordryness. Imagingtests:Theseincludesialometry,whichmeasureshowmuchsalivayouproducebyusingX-raysthatcanseedyeinjectedintosalivaryglands.Thereisalsosalivaryscintigraphy,awaytotrackhowlongittakesforaradioactiveisotopetotravelfromaninjectionpointinyourveintoyoursalivaryglands. Healthhistory:Ifyouhaveapre-existingautoimmunedisease,plusdryeyesanddrymouth,yourdoctormayconcludethatyouhavedevelopedsecondarySjögren’ssyndrome. ManagementandTreatment WhatkindofadoctortreatsSjögren’ssyndrome? ManytypesofdoctorsmightbeinvolvedinyourcareifyouhaveSS.Theseincludeyourownprimarycareprovider,yourdentist,andspecialistssuchasrheumatologists,ophthalmologistsandotolaryngologists,alsocalledear,noseandthroat(ENT)doctors. HowisSjögren’ssyndromemanagedortreated? ThereisnocureforSjögren’ssyndrome,buttreatmentscanrelievesymptoms.Dependingonyourspecificissues,yourdoctormayrecommendoneormoreofthesetherapies. Treatmentsfordryeyes: Artificialtears:Over-the-counterartificialteareyesolutionsandartificialteareyeointmentsmoisturizedryeyes.Theseproductsrelieveirritationanddiscomfort. Prescriptioneyedrops:Cyclosporine(Restasis®)andlifitegrast(Xiidra®)prescriptioneyedropssootheinflamedtearglandsandstimulatetearproduction. Punctalplugs:Anophthalmologistinsertstinysiliconeplugsintothetearducts.Theplugsblocktheductssotearsstayontheeyes,keepingthemwet. Surgery:Ifpunctalplugsworkforyou,yourdoctormayrecommendsurgerytoclosethetearductspermanently. Autologousserumdrops:Yourdoctorcanmakecustomizedartificialtears.Theprocessinvolvesmixingyourbloodserum(aclearliquidseparatedfromyourblood)withasterileliquidsolution.Youreceiveaone-of-a-kindtearsubstituteuniquetoyourbody.Whileeffective,thepriceytreatmentisn’talwayscoveredbyinsurance. Treatmentsfordrymouth: Salivaproducers:Productssuchasgumandhardcandiesthatcontainsweetenerslikesorbitolorxylitolcanstimulatesalivaproduction.Youcanalsouseanover-the-counterorprescriptionsalivasubstitute.Prescriptionproductsincludesorbitolorallozengesandsorbitoloromucosalsolutions(solutionsthataredirectedtowardthecheeks). Prescriptionmedications:Pilocarpine(Salagen®)andcevimeline(Evoxac®)pillsincreasethenaturalproductionofsaliva. Dentalcare:Adrymouthincreasestheriskofdentalcavities,infectionsandtoothdecay.Yourdoctormayrecommendaprescriptiontoothpasteandmouthwash,aswellasregularfluoridetreatments. Treatmentsforjointororganproblems: Over-the-counterpainrelievers:Acetaminophen(Tylenol®)andnonsteroidalanti-inflammatorydrugs(NSAIDs),suchasibuprofen(Motrin®)andnaproxen(Aleve®),canrelievejointpainandmuscleaches. Anti-rheumatics:Hydroxychloroquineprescriptionpillscandiminishpainfromrheumatoidarthritisorlupus.Thismedicationmayalsoreducesalivaryglandswelling. Immunosuppressants:Theseprescriptionmedicationsslowtheimmunesystem’sresponse.Theylesseninflammationandpreventorgandamage. Steroids:Prednisoneprescriptionpillssootheinflammationofthejoints,skinandorgans. Antifungals:Thesemedicationstreatyeastovergrowthinyourmouth(oralthrush)orinyourvagina(vaginalyeastinfection). Treatmentsforvaginaldryness: Ifyourvaginaisalwaysdry,itchyandsore,youshouldcheckwithyourhealthcareprovidertomakesurethattheissueisnotsomethingmorethanhormonalchanges.Youmighthavesometypeofinfectionorskinissue.Theseconditionswouldrequirespecifictreatments.Ingeneral,though,womenwithSjögren’ssyndromearetwotothreetimesmorelikelytohaveissueswithvaginaldrynessandatrophythanwomenofsimilaragesaroundandaftermenopause.Tipsforhelpingwitheverydayvaginaldrynessinclude: Tryingvaginalmoisturizersorlubricantstoaddmoisturetothevaginadailyandtoeasesexualintercourse. Usingunscentedsoapsforcleansing.Perfumesandotheradditivescancauseirritation. Askingyourhealthcareprovideraboutvaginalestrogentherapy. WhatarethecomplicationsofSjögren’ssyndrome? MostpeoplewhohaveSjögren’ssyndromelivetheirliveswithoutanysignificantproblems.However,adrymouthmeansthatyouaremorelikelytohavedentalproblems,suchastoothdecayandinfection.Dryeyescanalsoplaceyouatriskforeyeinfections. IfyouhavesecondarySjögren’ssyndrome,youmayalsohaveproblemslikejointpaintcausedbyrheumatoidarthritisorlupus. Rarely,peoplewithSjögren’ssyndromedevelopthesecomplications: Abnormalliverorkidneyfunction. Lymphomas(canceroustumorsinthelymphnodes). Lungproblemsthatmaybemistakenforpneumonia. Neurologicalproblemsthatcauseweaknessornumbness. Skinrashes(redskin). Prevention HowcanIpreventSjögren’ssyndrome? BecausenooneknowsexactlywhatcausesSjögren’ssyndromeorotherautoimmunediseases,thereisnoknownwaytopreventit. Outlook/Prognosis Whatistheprognosis(outlook)forpeoplewithSjögren’ssyndrome? Constantlyhavingadrymouthordryeyesiscertainlyuncomfortable.Fortunately,symptomstendtolessenovertime.Withtherighttherapies,youcanmanagesymptomssotheydonotinterferewithyourabilitytoenjoylife. DoesSjögren’ssyndromecauseweightgain? Sjögren’ssyndromedoesn’tcauseweightgain.However,medications(likesteroids)usedtotreatsymptomsmaycauseweightgain.Also,thereareconditionslikehypothyroidismthatmaybelinkedtoSjögren’ssyndromethatcanresultinunintendedweightgain. DoesSjögren’ssyndromeaffectears? Sjögren’ssyndrome,likeotherautoimmuneconditions,canaffectears,too.Youmighthavetroublewithhearinglossorwithbalance. LivingWith WhatshouldIeatifIhaveSjögren’ssyndrome?WhatfoodsshouldIavoid? Anestimated90%ofpeoplewithSjögren’ssyndromehaveproblemsrelatedtoeating.Insomecases,theseproblemscanbeenoughtocausemalnutrition.Troublescanberelatedtodrynessandswellingofthethroat,aswellasintestinaltractornervedamage.TherealsoseemstobeasignificantnumberofpeoplewhohavebothSjögren’ssyndromeandceliacdiseaseand/orsymptomsofirritablebowelsyndrome(bloating,abdominalpain,diarrheaand/orconstipation). Ifyouhavegastrointestinalsymptoms,youcanworkwitharegistereddietitian(RD)tofindoutwhatfoodsensitivitiesyouhave.AnRDcanthenalsohelpyoutocreateafoodplanthatworkswellforyouandprovidesthenutrientsyouneed. Problemswithgastroesophagealreflux(GERD)arealsocommonamongpeopleingeneralandamongpeoplewithSjögren’ssyndromeinparticular.YourcareteamcanprovideyouwithtipsfordealingwithGERD.Thesemightincludenoteatingtwotothreehoursbeforeyouliedowntosleepandavoidinggreasyfoods. TherearesomerecommendationsthatpeoplewhohaveautoimmunedisorderslikeSjögren’ssyndromeshouldfollowananti-inflammatorydiettohelpwithjointpainandothersymptoms.Somepeoplehavefoundrelieffromacompletelyplant-baseddiet. Herearesometipsthatmighthelpyoumanageothertypesofeatingissues: Eatsmalleramountsoffoodatonetime,buteatmorefrequentlythroughouttheday. Includesoftfoodsinyourdiet. Besuretochewyourfoodcompletely. Avoidcavitiesbyreducingtheamountofsugaryoueatanddrinkingonlywaterbeforeyougotobed. IsSjögren’ssyndromeconsideredadisability? TheU.S.governmenthasawardeddisabilitytopeoplewithseverecasesofSjögren’ssyndrome.However,thisisaquestionthatyoushoulddiscusswithyourhealthcareprovidertoseeifyouareeligible. DoesSjögren’ssyndromecausehairloss? IfyouhaveSjögren’ssyndrome,youmightseesomehairloss,anditmightbeasaresultofthecondition.Thereisaconditionknownasfrontalfibrosingalopeciathatisbeingfoundinhighernumbersinpeople(mostlywomen)withautoimmunediseases.Thisconditioncausesslowhairlossatthefronthairlineandsometimestheeyebrows. However,hairlosscanbetriggeredbymanythings,includingstressfullifeeventsandmedications.Youshouldaskyourdermatologistaboutproblemswithhairloss. WhenshouldIcallthedoctorifIhaveSjögren’ssyndrome? Severemouthorgumpaincouldindicateinfectionortoothdecay.Itchyeyes,eyepain,orblurredordoublevisioncansignalinfectionsorothervisionproblems.Youshouldalsocallyourdoctorifyounoticeswollenlymphnodesinyourneck,armpitsorgroin.Enlargedlymphnodescouldindicatelymphomaoranotherhealthcondition. WhatquestionsshouldIaskmydoctorifIhaveSjögren’ssyndrome? IfyouhaveSjögren’ssyndrome,youmaywanttoaskyourdoctor: WhatlifestylemeasurescanItaketomakemysymptomsmorelivable? Cancertainmedications,drinksorfoodsdryouttheeyesormouth? ShouldIlookoutforanysignsofcomplications? AnotefromClevelandClinic Whilethereisn’tacureforthedrymouth,dryeyesorotherproblemscausedbySjögren’ssyndrome,youdon’thavetolivewithdiscomfortorpain.Talkopenlywithyourhealthcareproviderabouthowthediseaseaffectsyoureverydaylife.Eating,swallowing,speakingandseeingareallcriticalforenjoyinglife.Yourprovidercanhelpyoufindtherightcombinationoftherapiestorelievesymptoms. Share Facebook Twitter LinkedIn Email Print Getuseful,helpfulandrelevanthealth+wellnessinformation enews ClevelandClinicisanon-profitacademicmedicalcenter.Advertisingonoursitehelpssupportourmission.Wedonotendorsenon-ClevelandClinicproductsorservices. 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