A systemic inflammatory disorder characterized by dry mouth, decreased tearing , and other dry mucous membranes and often associated with autoimmune rheumatic disorders.

Causes, incidence, and risk factors

The cause of Sjogren syndrome is unknown. The syndrome occurs most often in women 40 to 50 years old. It is rare in children. Pediatric patients usually present with another autoimmune disorder before developing the signs of Sjogren syndrome. Dryness of the eyes and mouth are the most common symptoms of this syndrome; they may occur alone, or with symptoms associated with rheumatoid arthritis or other connective tissue diseases. There may be an associated enlargement of the salivary glands. Other organs may become affected. The syndrome may be associated with rheumatoid arthritis, systemic lupus erythematosus , scleroderma , polymyositis , and other diseases. The prevalence of the disease is 3%.

Signs and tests

A

physical examination reveals dry eyes and mouth. Mouth sores may be present because of the mouth dryness. Tests:

positive antinuclear

antibodies ( ANA ) test

positive

salivary gland biopsy

positive

rheumatoid factor (possible)

tear test

slit lamp examination

with rose bengal dye

This disease may also alter the results of the following tests:

antithyroid microsomal antibody

antithyroglobulin antibody

Treatment

The objective of treatment is to provide

symptomatic relief. Dry eyes may be treated with artificial tears as often as needed or an ocular (eye) lubricating ointment may be applied at bedtime. Dry mouth may helped by sipping water throughout the day, chewing sugarless gum, and avoiding drugs that cause mouth dryness such as antihistamines and decongestants. There are also drugs available (e.g., Pilocarpine) that increase the flow of saliva. Frequent brushing and flossing of the teeth with regular dental visits may prevent severe dental cavities associated with the dry mouth. Arthritis symptoms may be mild and are treated as for the specific disorder. Commonly, this includes nonsteroidal anti-inflammatory medications and physical therapy.

Expectations (prognosis)

The disease is usually benign and prognosis (probable outcome) is affected by associated diseases. There is an increased incidence of lymphoma .

Complications

pulmonary infection

renal failure

(rare)

lymphoma

Calling your health care provider

Call for an appointment with your health care provider if you develop symptoms of Sjogren syndrome.