Sjögren's Syndrome: When the Immune System Dries You Out

Sjögren's syndrome, also called Sjögren's disease, is a chronic autoimmune disease: the immune system, which normally protects against infection, attacks healthy tissue by mistake. In Sjögren's it targets the glands that make moisture — in the eyes, the mouth and elsewhere — causing dry eyes and a dry mouth, and sometimes a dry nose, throat and skin. It can also affect the joints, lungs, kidneys, blood vessels, digestive organs and nerves.

Causes

Nobody knows for sure what sets the immune system off. Researchers think it is a mix of genetic and environmental factors: Sjögren's has been linked to changes in several genes, and something in the environment — possibly an earlier viral or bacterial infection — may trigger it.

Who gets it

• Most people with Sjögren's are women.
• It can start at any age but is most common in people in their 40s and 50s.
• It is more common in people with other autoimmune diseases such as rheumatoid arthritis and lupus — secondary Sjögren's. Without another autoimmune disease, it is primary Sjögren's.

Symptoms

Symptoms vary from person to person, and some people cycle between mild and severe.

Other possible symptoms: joint and muscle pain; dry skin; rashes on the hands or feet; numbness or tingling in the hands or feet; vaginal dryness; a dry cough that won't go away; fatigue that won't go away.

Diagnosis

There is no single test. A health care provider will take your history, examine you for signs of dry mouth and related autoimmune diseases, and may order:

• eye tests — whether you make a normal amount of tears, and whether dryness has damaged your eyes;
• salivary gland tests — how much saliva you make, possibly with imaging and a biopsy;
• blood tests.

Treatment

There is no cure; treatment relieves symptoms, depending on which parts of the body are affected:

• artificial tears or ointments for dry eyes;
• saliva substitutes, and prescription medicines that make the salivary glands produce more saliva;
• small plugs in the tear ducts at the corners of the eyes, so tears stay longer;
• medicines for other symptoms, such as pain and inflammation;
• medicines that suppress the immune system, for severe cases.

At home: suck sugar-free candy, sip water often, make your room more humid, and don't smoke. A dry mouth raises the risk of cavities, so take good care of your teeth and see your dentist regularly.

Sources

Based on "Sjogren's Syndrome," MedlinePlus, National Library of Medicine; a work of the United States government in the public domain.