Sjögren's Disease

Sjögren’s disease is a chronic, autoimmune disease. It can occur alone or with other autoimmune conditions like rheumatoid arthritis (RA) or lupus. Sjögren’s presents with dry eyes and dry mouth. Inflammation of the tear ducts and saliva glands cause dryness and irritation. Other common symptoms include joint and muscle pain, fatigue, and rashes. Less commonly, it can affect internal organs such as the lungs, gastrointestinal tract, kidneys, and nervous system. Sjögren’s affects women about 10 times more often than men and usually occurs between 45 and 55. Symptoms can range, but patients can often lead a normal life. Rarely, it can cause complications like an increased risk of lymphoma, a type of cancer.

What Are the Signs/Symptoms?

Dry eyes and dry mouth are common symptoms of Sjögren’s. The eyes may turn red, burn, or feel gritty like sand in your eyes. It may be hard to eat dry foods or swallow because of lack of saliva. Glands of the neck or face may swell up. Other symptoms include dryness of skin, vagina, nasal passages and throat; heartburn; joint and muscle pains; fatigue; and rashes. Because of chronic dryness, patients may be at risk for eye infections or cornea damage, tooth decay or gum disease, and vaginal yeast infections.

Diagnosing Sjögren’s includes a physical exam, blood tests and sometimes a biopsy. An eye exam by the ophthalmologist may be necessary to evaluate dry eyes. A rheumatologist can do blood tests for anti-nuclear antibodies (ANA), anti-SSA (Ro) and SSB (La) antibodies, and rheumatoid factor (RF), or obtain a salivary gland biopsy to make a diagnosis.

What Are Common Treatments?

Treatments for Sjögren’s relieve symptoms of dryness and prevent problems like infections or dental disease. Treatments for dry eyes include artificial tears or eye gels; eye drops such as cyclosporine (Restasis) to increase tear production. For dry mouth, sips of water or chewing gum may help, but some patients need prescription drugs like pilocarpine (Salagen) or cevimeline (Evoxac) to increase saliva production. Patients with reflux may use proton-pump inhibitors or H2 blockers. Depending on the symptoms and organ system involved, some people with Sjögren’s may need hydroxychloroquine, corticosteroids (Deltasone), methotrexate (Rheumatrex), azathioprine (Imuran), mycophenolate (Cellcept), rituximab (rituxan), or cyclophosphamide (Cytoxan) in life threatening cases.

Care/Management Tips:

Here are some tips for living with Sjögren’s disease:

• Get regular dental check-ups to prevent tooth decay and cavities
• Get regular eye exams with an ophthalmologist to check for cornea damage or infections
• Get regular follow up with a rheumatologist who can treat symptoms and monitor for complications

Updated February 2023 by Kristen Lee, MD, and reviewed by the American College of Rheumatology Committee on Communications and Marketing. This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis, and treatment of a medical or health condition.