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Sjogren syndrome

Definition
Sjogren syndrome is an autoimmune disorder that causes a major decrease in lubricating fluids, such as tears and saliva. An autoimmune disorder is one in which the person's body attacks its own tissues, for unknown reasons.

What is going on in the body?
In Sjogren syndrome, the body's natural defence mechanisms invade and destroy the glands that produce saliva, tears, and other lubricating fluids. Since the body produces less saliva and fewer tears, the eyes and mouth become dry. Women may notice vaginal drying. A person may have Sjogren syndrome alone or with other autoimmune disorders. These include rheumatoid arthritis and systemic lupus erythematosus.

What are the signs and symptoms of the disease?
Symptoms associated with the decreased saliva in Sjogren syndrome are: Symptoms associated with decreased tearing are:
  • dry, red eyes
  • feeling of sandy or gritty feeling under the eyelids
  • itching, burning sensation
  • thick stringy oozing in the corners of eyes
  • eye fatigue or strain
  • increase sensitivity to light
  • severe eye pain, caused by corneal injuries
What are the causes and risks of the disease?
Sjogren syndrome occurs in about 2 out of 10,000 people. The exact cause is not known. Sjogren syndrome occurs in more women than men at a ratio of 9:1. It affects mostly middle-aged women but can occur in all ages. Thirty percent of people who have other autoimmune disorders also suffer from secondary Sjogren syndrome.

What can be done to prevent the disease?
There is no known prevention for Sjogren syndrome.

How is the disease diagnosed?
The diagnosis of Sjogren syndrome is made primarily by physical examination of the eyes, mouth, and mucous membranes, such as the vagina. Eyes are checked for corneal injuries, or scratches. The eyes are also checked for their ability to produce tears. Sometimes a small sample of the gland that produces saliva is removed and checked under a microscope.

What are the long-term effects of the disease?
The most common long-term effects of Sjogren syndrome are due to the loss of lubricating fluids of the eyes and mouth. A person will need to prevent injuries to the eyes and mouth to keep from losing more of these fluids.

What are the risks to others?
Sjogren syndrome is not contagious, and causes no risks to others.

What are the treatments for the disease?
A person with Sjogren syndrome usually uses artificial tears to keep the eyes moist. Artificial saliva is used to prevent dry mouth. Frequent sips of water throughout the day may also be helpful for dry mouth. An individual with Sjogren syndrome should avoid medications that are known to dry up secretions. These medications include antihistamines, decongestants, and some sleeping medications. Any other autoimmune disorder present will also need treatment. Sometimes medications to suppress the body's immune response are prescribed.

What are the side effects of the treatments?
The artificial tears and saliva have no side effects. Medications that suppress the body's immune system can leave a person more likely to get infections.

What happens after treatment for the disease?
Complications of Sjogren syndrome include increased dental cavities, kidney failure, and sore or scratches on the eye that can lead to blindness.

How is the disease monitored?
Any new or worsening symptoms should be reported to the doctor.

Author: James Broomfield, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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