Definition

Sjogren’s (SHOW-grins) syndrome is a disorder of your immune system identified by its two most common symptoms — dry eyes and a dry mouth.

Sjogren’s syndrome often accompanies other immune system disorders, such as rheumatoid arthritis and lupus. In Sjogren’s syndrome, the mucous membranes and moisture-secreting glands of your eyes and mouth are usually affected first — resulting in decreased production of tears and saliva.

Although you can develop Sjogren’s syndrome at any age, most people are older than 40 at the time of diagnosis. The condition is much more common in women. Treatment focuses on relieving symptoms.

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Symptoms

The two main symptoms of Sjogren’s syndrome are:

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Some people with Sjogren’s syndrome also experience one or more of the following:

Causes

Sjogren’s syndrome is an autoimmune disorder. This means that your immune system mistakenly attacks your body’s own cells and tissues.

Scientists aren’t certain why some people develop Sjogren’s syndrome and others don’t. Certain genes put people at higher risk of the disorder, but it appears that a triggering mechanism — such as infection with a particular virus or strain of bacteria — is also necessary.

In Sjogren’s syndrome, your immune system first targets the moisture-secreting glands of your eyes and mouth. But it can also damage other parts of your body, such as your:

Risk Factors

Although anyone can develop Sjogren’s syndrome, it typically occurs in people with one or more known risk factors. These include:

Complications

The most common complications of Sjogren’s syndrome involve your eyes and mouth.

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Less common complications may affect your:

Preparing for Your Appointment

You may initially bring your symptoms to the attention of your family doctor, your dentist or your eye doctor. However, you may eventually be referred to a rheumatologist — a doctor who specializes in the treatment of arthritis and other inflammatory conditions — for diagnosis and treatment.

What you can do

You may want to write a list that includes:

For Sjogren’s syndrome, some basic questions you may want to ask your doctor include:

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Questions that might come up:

Tests and Diagnosis

Sjogren’s syndrome can be difficult to diagnose because the signs and symptoms vary from person to person and can be similar to those caused by other diseases. Side effects of a number of medications also mimic some signs and symptoms of Sjogren’s syndrome.

A variety of tests can help rule out other conditions and help pinpoint a diagnosis of Sjogren’s syndrome.

Blood tests

Your doctor may order blood tests to check for:

Eye tests

Your doctor can measure the dryness of your eyes with a test called a tear osmolarity test. Your eye doctor will take a sample of tears from each eye and use the TearLab device to measure osmolarity (the saltiness of your tears). As osmolarity in your tears increase ocular surface cells become damaged. Your doctor will need an amount of tear fluid no larger than the period at the end of this sentence.

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A doctor specializing in the treatment of eye disorders (ophthalmologist) may also examine the surface of your eyes with a magnifying device called a slit lamp. He or she may place drops in your eye that make any damage to your cornea easier to see.

Imaging

Certain imaging tests can check the function of your salivary glands.

Biopsy

Your doctor may also want to do a lip biopsy to detect the presence of clusters of inflammatory cells, which can indicate Sjogren’s syndrome. For this test, a small sliver of tissue is removed from salivary glands located in your lip and examined under a microscope.

Treatments and Drugs

Many people can manage the dry eye and dry mouth associated with Sjogren’s syndrome by using over-the-counter eyedrops and sipping water more frequently. But some people may need prescription medications, or even surgery.

Medications

Depending on your symptoms, your doctor may suggest medications that:

Surgery

To relieve dry eyes, you may consider undergoing a minor surgical procedure to seal the tear ducts that drain tears from your eyes (punctal occlusion). Collagen or silicone plugs are inserted into the ducts for a temporary closure. Collagen plugs eventually dissolve, but silicone plugs stay in place until they fall out or are removed. Alternatively, your doctor may use a laser to permanently seal your tear ducts.

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Lifestyle and Home Remedies

Many symptoms of Sjogren’s syndrome respond well to self-care measures.

To relieve dry eyes:

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To help with dry mouth:

Oral health

Dry mouth increases your risk of dental cavities and tooth loss. The following precautions may help prevent those types of problems.

Other areas of dryness

If dry skin is a problem, avoid hot water when you bathe and shower. Pat your skin — don’t rub — with a towel and apply moisturizer when your skin is still damp. Use rubber gloves when doing dishes or housecleaning. Vaginal moisturizers and lubricants help women who experience vaginal dryness.