Sjögren’s syndrome

What is Sjögren’s?

In Sjögren’s (say “SHOW-grins”), the immune system attacks the glands that make tears and saliva. The inflammation damages these glands, so they make less moisture¹. In some people, it also affects other parts of the body, such as the joints, lungs, kidneys, and nerves¹.

Sjögren’s can happen on its own or alongside another autoimmune disease, such as rheumatoid arthritis or lupus^1,3. Many groups, including the National Institutes of Health and the American College of Rheumatology, now use the name Sjögren’s disease. Both names mean the same condition¹.

Symptoms of Sjögren’s

Symptoms vary from person to person, and they can cycle between mild and severe¹. Common symptoms include:

• Dry eyes that burn, itch, or feel gritty, like sand is in them¹
• Dry mouth that makes it hard to swallow, speak, or taste¹
• More cavities and mouth infections, such as thrush¹
• Swollen glands around the face and neck¹
• Feeling very tired¹
• Joint and muscle pain¹
• Dry skin, dry nose and throat, a dry cough, or vaginal dryness¹
• Numbness or tingling, often in the hands or feet¹

People with Sjögren’s have a higher chance of a type of cancer called lymphoma, though the risk is low¹.

Causes and risk factors

Researchers don’t know exactly what turns the immune system against these glands. Both genes and things in the environment likely play a part¹.

• Most people with Sjögren’s are women. It affects women about 10 times as often as men³.
• It can start at any age, but it is most common in people in their 40s and 50s¹.
• Having another autoimmune disease, such as rheumatoid arthritis or lupus, raises the chance^1,4.

How Sjögren’s is diagnosed

There is no single test for Sjögren’s. Diagnosis is based on how well your tear and saliva glands work and whether there are signs of autoimmunity². Testing may include:

• Questions about your dryness: when it started and whether you feel it every day²
• Blood tests for antibodies, such as ANA, anti-SSA (Ro), anti-SSB (La), and rheumatoid factor. These help, but some healthy people have them too^2,3
• Eye tests that measure tears and check the eye surface for damage, often with an eye doctor^2,3
• Tests that measure how much saliva you make, and sometimes an ultrasound of the salivary glands²
• A small sample of tissue from the inner lip (biopsy), sometimes needed when blood tests are negative³

Treatment options

Treatment focuses on relieving symptoms and preventing problems from dryness. Your plan depends on which parts of your body are affected². Options include:

• Artificial tears, eye gels, and ointments, plus prescription eye drops that reduce inflammation^2,3
• Tiny plugs placed in the tear ducts to keep tears in the eyes longer²
• Saliva substitutes and medicines that help your glands make more saliva^2,3
• Medicines for joint and muscle pain²
• Medicines that calm the immune system, for people whose joints, lungs, kidneys, or nerves are affected³

Tell your clinician about every medicine you take, since some make dryness worse².

Living with Sjögren’s and when to get care

Most people with Sjögren’s can expect to live a normal life². Everyday steps that help^2,3:

• Sip water through the day, and try sugar-free gum or candy to help saliva flow
• Brush and floss daily, and see a dentist at least twice a year
• Get regular eye exams
• Use a humidifier and protect your eyes from wind and smoke
• See your rheumatologist regularly to check for complications

Ask your clinician about seeing a rheumatologist if you have dry eyes or dry mouth that won’t go away, especially with tiredness, joint pain, or swollen glands. Tell your care team about new swelling in your neck or face¹.

When to go to the emergency room

Call 911 or go to the nearest emergency room if you feel like you can’t breathe or swallow⁴.