Sjogren Syndrome

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What is it?

Sjögren syndrome is an inflammatory disorder that affects the mucous membranes, causing dry mouth, decreased tear production, and dryness of other body membranes. It usually occurs in women around 50 years old, and the cause is unknown. Sjögren syndrome can occur as a primary disorder or secondarily in association with other well-defined autoimmune diseases such as rheumatoid arthritis (RA), progressive systemic sclerosis (PSS), polymyositis (PM), and systemic lupus erythematosus (SLE). In Australia involvement of organs such as brain, kidney and lung is uncommon.

Symptoms may include dry and gritty eyes, dry mouth with difficulty chewing and swallowing, decreased sense of taste and smell, joint pain, and swollen glands. There is an increased incidence of lymphoma, particularly of the parotid gland, among patients with this syndrome.

Tests
Tests for Sjögren syndrome may include:

  • Antinuclear antibodies (ANA) (positive)
  • Rheumatoid factor (RF) (often positive)
  • Antibodies specific to Sjögren syndrome (SS): anti-SS-A and SS-B; SS-A is also called Ro, while SS-B is also called La (usually positive). These come under the term ENA (extractable nuclear antigens). Some consider these an absolute requirement for the diagnosis of Sjögren syndrome
  • Polyclonal activation of IgG is commonly seen, i.e. all IgG type immunoglobulins are increased

Treatment
Treatment is based on the symptoms. Dry eyes are treated with artificial tears, a tear stimulant, or eye lubricant. A dry mouth may be helped by frequent small drinks of water or chewing gum to stimulate saliva production. Arthritis symptoms are treated with anti-inflammatory medicines, such as aspirin, and other NSAIDs, although rarely immune suppressants similar to those used in RA are needed.

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