PAINFULLY DRY EYES AND MOUTH
Sjögren’s (pronounced show-grens) syndrome is an autoimmune condition. The body’s immune system turns against itself, subsequently destroying the exocrine glands that produce tears, saliva and mucus. The condition was first described in 1933 by the Swedish physician Henrik Sjögren. He reported women whose arthritis was associated with dryness of their eyes and mouth.
When these symptoms occur without any other rheumatologic condition, it is described as “primary” Sjögren’s syndrome. When it occurs with another rheumatologic condition such as lupus, RA or scleroderma, it is called “secondary” Sjögren’s syndrome.
The cause of Sjögren’s syndrome is unknown, although scientists believe that genetically predisposed patients may come in contact with a virus or certain bacteria that triggers the immune response. This response inactivates tear and saliva glands. The result is uncomfortably dry eyes and dry mouth. People with Sjögren’s often describe eye irritation and grittiness, as if there is sand in their eye. A burning sensation in the mouth or throat is also common, as is a hoarse voice or difficulty swallowing because food sticks to the dry tissue. Enlarged or infected glands that cause pain are also common, as is vaginal dryness among women. Many patients also complain of aching and fatigue.
Sjögren’s syndrome affects approximately 1 in 2500 people, but the condition is frequently overlooked. A blood test can help to diagnosis the condition. Most people with Sjögren’s syndrome have at least one antibody in their blood that is a specific marker for the disease. The markers that may be present in Sjögren’s syndrome include:
Antibodies to the rheumatoid factor (RF), which are found in RA and Sjögren’s syndrome
Those to the anti-nuclear antibodies (ANA), which are found in RA, Sjögren’s syndrome, lupus and scleroderma
Those to anti-Sjögren’s syndrome A (anti-SSA or “Ro”), which are found in RA, Sjögren’s syndrome and lupus
Those to anti-Sjögren’s syndrome B (anti-SSB or “La”), which is diagnostic for primary Sjögren’s syndrome
Definitive diagnosis is based on a thorough history and physical examination as well as the results of the laboratory tests to detect the presence of the antibodies that are characteristic of Sjögren’s syndrome. A biopsy of the minor salivary gland found in the lips may also be performed. There is no treatment that is capable of producing normal glandular conditions, so treatment focuses on treating symptoms of dry eyes and mouth. Lubricants, as well as medications that decrease inflammation, stimulate moisture and help patients to feel better.
Scott Zashin, MD, PA is a respected Texas Sjögren's Syndrome Doctor/Specialist in Dallas. The above information about Sjögren's Syndrome is from his arthritis book: Arthritis Without Pain, a comprehensive guide for patients considering or undergoing treatment with the TNF blockers Enbrel®, Remicade®, or Humira®. All rights reserved.