Doctor's Notes on Sjögren's Syndrome
Sjögren's syndrome is an autoimmune disorder that affects the body’s moisture-producing glands, such as the tear glands (lacrimal glands) and the salivary glands. These glands become infiltrated with white blood cells (lymphocytes) that causes the glands to produce less moisture, leading to dryness of the eyes and mouth.
The main symptoms of Sjögren's syndrome include dry eyes and dry mouth. The inside of the nose, the skin, the airways of the lungs, and the vagina can also be dry. Fatigue and joint pain may also occur. Dry mouth can cause symptoms such as difficulty chewing or swallowing, inability to eat dry foods, cracked or sore tongue, tongue sticking to the roof of the mouth, dry and burning throat that leads to a dry cough, awakening at night with the need for a drink of water, difficulty speaking continuously, hoarseness, high incidence of tooth decay and gum disease, changes in taste, difficulty wearing dentures, and cracks and redness in the corners of the mouth. Dry eyes can cause symptoms such as red, itchy, or painful eyes; gritty, scratchy, burning, or sandy sensation in the eyes; eyes matted and stuck closed on awakening; blurred vision; sensitivity to bright light; or damage to the cornea.
Sjögren's Syndrome Symptoms
The defining symptoms of Sjögren's syndrome are dry eyes (xerophthalmia) and dry mouth (xerostomia). Other areas can be dry as well, such as the inside of the nose, the skin, the airways of the lungs, and the vagina. These symptoms often are referred to as the sicca (dryness) complex.
A dry mouth can cause
- difficulty chewing or swallowing;
- inability to eat dry foods, such as crackers, that stick on the roof the mouth;
- cracked or sore tongue, or tongue sticking to the roof of the mouth;
- dry, burning throat that leads to a dry cough;
- awakening at night with the need for a drink of water;
- difficulty speaking continuously;
- high incidence of dental decay and periodontal disease;
- change in the sense of taste;
- difficulty wearing dentures;
- cracks and redness in the corners of the mouth.
Dry eyes can cause
- red, itchy, or painful eyes;
- gritty, scratchy, burning, or sandy sensation in the eyes;
- eyes matted and stuck closed on awakening;
- blurry vision;
- sensitivity to bright light that makes reading or watching television difficult;
- damage to the cornea, the dome over the colored portion (iris) of the eye.
Almost every system of the body can be affected. Symptoms depend on which areas are affected and may include any of the following:
- Painful swelling of the parotid (salivary) glands: These glands are located between your ear and the angle of your jaw.
- Tiredness (fatigue) that can be severe enough to interfere with normal activities
- Joint pain (arthralgia) and occasionally joint swelling (arthritis)
- Dry and itchy skin
- Red-purple skin lesions (palpable purpura) that commonly occur on the legs: These occur when blood vessels in the skin become inflamed
- Episodic white, blue, and red discoloration of the fingers or toes (Raynaud's phenomena)
- Painful sexual intercourse (dyspareunia)
- Dry cough
- Difficulty swallowing
- Recurrent pneumonia and bronchitis
- Acid reflux and heartburn
- Severe abdominal pain that could be due to pancreatitis or kidney stones
- Inflammation of the bladder causing frequent urination, lower abdominal pain, and pain on urination
- Thyroid disease may also accompany Sjögren's syndrome
Symptoms are mild in most people but can be very severe in others. Symptoms can vary over time and may improve, worsen, or even go away completely for periods of time.
Dry eyes and mouth do not always mean Sjögren's syndrome. The symptoms are common and can be caused by other medical disorders, by some medications, and by anxiety. It is important to consider other diseases that produce similar symptoms. Dryness also may be a result of normal changes in glands and tissues that occur with aging, previous radiation to the head and neck, lymphoma, sarcoidosis, hepatitis C, human immune deficiency virus, human T-cell leukemia virus-1 infection, cancer, inflammatory disease, infections, and medications.
Sjögren's Syndrome Causes
The cause of Sjögren's syndrome is not known. The infiltration of moisture-producing glands by lymphocytes is an autoimmune response. This means that the body's immune system mistakenly attacks the body's own cells. The infiltration of lymphocytes can damage the gland. Precisely what causes this to happen is not known, but it is probably a combination of genetic (inherited) factors and unknown environmental factors.
Dry mouth is that uncomfortable feeling you get when you’re not generating enough saliva to meet your needs. When your mouth fails to produce enough saliva, you will find yourself with more problems than just being thirsty.
By salivating, your mouth helps you taste and digest what you eat and drink. Food particles get flushed from your teeth and acid is washed away as well, which helps prevent tooth decay (cavities).
In this series, learn some of the many causes of dry mouth (also known as xerostomia), along with its symptoms, treatments, and remedies. This knowledge could be crucial to the ongoing health of your teeth and mouth.
Rheumatoid Arthritis : What is Rheumatoid Arthritis? QuizQuestion
The term arthritis refers to stiffness in the joints.See Answer
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.