About Sjögren’s syndrome

About Sjögren’s syndrome

Sublingual gland biopsy, showing tissue destruction resulting in loss of saliva.
Sublingual gland biopsy, showing tissue destruction resulting in loss of saliva.

In Sjögren’s syndrome, immune cells infiltrate and destroy the mucus-producing glands of the body.

Sjögren’s syndrome can occur by itself (known as Primary Sjögren’s syndrome), or together with other autoimmune diseases like lupus or rheumatoid arthritis. This is known as Secondary Sjögren’s syndrome.

Although the specific cause of Sjögren’s syndrome is somewhat of a mystery, there appears to be a genetic influence. It tends to occur more commonly in families that have other autoimmune diseases (e.g. lupus, scleroderma or mixed connective tissue disease). It is also thought several factors can trigger the disease – including viral infections, hormones and stress.

There’s currently no cure for Sjögren’s syndrome, but proper treatment should provide comfort and relief of symptoms. 

  • Risks
  • Symptoms
  • Diagnosis & treatment

90% of people with Sjögren’s syndrome are women. On average they are diagnosed between the ages of 40 and 50.

As most patients are women, the antibodies in their blood can be passed to an unborn child via the placenta. This can lead to the development of neonatal heart block and can stop the baby’s heart from working properly. Approximately 1 in 50 pregnant mothers with Sjögren’s syndrome have a child with neonatal heart block. The incidence of neonatal heart block increases to 1 in 5 for subsequent pregnancies in mothers who previously had a child with neonatal heart block.

Some patients with Sjögren’s have enlarged lymph glands and spleens; this can lead to an increased risk of developing cancer, specifically lymphomas.

Like many autoimmune diseases, people with Sjögren’s syndrome are at increased risk of developing cardiovascular disease, potentially due to ongoing inflammation. Other serious but less common complications affect kidney, lung and liver function.

The symptoms vary greatly between individuals and may include:

  • Dry eyes and few or no tears: the most frequent complaint is the sensation of a foreign body in the eye. Redness, burning, light sensitivity, eye fatigue and itching may also be present.
  • Dry mouth: including difficulty chewing, swallowing food or speaking. Ulceration of the tongue and cheek membranes, a burning feeling on the tongue, altered taste sensation and the need to frequently drink fluids are common.
  • Bacterial overgrowth in the mouth: saliva is important for its antibacterial function, so without adequate saliva, dental decay, periodontal disease and oral yeast infections may develop.
  • Dry ear and nose: this may result in Eustachian problems of the middle ear or crusts, bleeds and a reduced sense of smell.
  • Fatigue and/or depression.
  • Vaginal dryness.
  • Swelling and pain in the joints.
  • Numbness and pins and needles.
  • Muscle weakness.
  • Dizziness.
  • Nausea, vomiting, early satiety and abdominal bloating.
  • Kidney stones.

Blood tests can detect certain antibodies in Sjögren’s syndrome, although this isn’t a thorough diagnosis.

A specialist eye examination, and occasionally kidney and lung function tests are needed to complete the diagnosis. Eye tests include Schirmer’s test: a paper strip that measure the production of tears. Normally people wet the paper very quickly, but in Sjögren’s syndrome, the paper may still be dry.

An ophthalmologist may perform a slit lamp examination, where a special lamp scans the surface of the eye and identifies abnormalities of secretion or the cornea. A dye that identifies mucous material may also be put into the eye to reveal a characteristic pattern for Sjögren’s syndrome. A lip biopsy may be taken under local anaesthesia to sample salivary glands and reveal the degree of damage.

There is currently no cure for Sjögren’s syndrome, so treatment aims to relieve the symptoms. A variety of artificial tear preparations can be used to treat dry eyes. There are some oral lubricants for treating symptoms of a dry mouth, but none are entirely satisfactory. Chewing sugarless gum may be helpful. Good dental hygiene and frequent visits to the dentist are essential. Moisturisers can help people with dry skin and lubricating creams may help dryness of the vagina. Oral medications, including non-steroidal anti-inflammatory drugs, can be used to treat swollen and painful joints.

This content is provided for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. If you have any concerns or questions about your health, please consult a suitably qualified healthcare professional.