BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuSjogren syndromeXerostomia - Sjögren syndrome; Keratoconjunctivitis sicca - Sjögren; Sicca syndrome; Sjögren syndrome; Sjögren's syndromeSjögren syndrome is an autoimmune disorder in which the glands that produce tears and saliva are destroyed. This causes dry mouth and dry eyes. The condition may affect other parts of the body, including the kidneys and lungs.Autoimmune disorderAn autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 autoimmune d...ImageRead Article Now Book Mark Article Causes The cause of Sjögren syndrome is unknown. It is an autoimmune disorder. This means the body attacks healthy tissue by mistake. The syndrome occurs most often in women ages 40 to 50. It is rare in children.Primary Sjögren syndrome is defined as dry eyes and dry mouth without another autoimmune disorder.Secondary Sjögren syndrome occurs along with another autoimmune disorder, such as:Rheumatoid arthritis (RA) Rheumatoid arthritisRheumatoid arthritis (RA) is a disease that leads to inflammation of the joints and surrounding tissues. It is a long-term disease. It can also aff...ImageRead Article Now Book Mark Article Systemic lupus erythematosus Systemic lupus erythematosusSystemic lupus erythematosus (SLE) is an autoimmune disease. In this disease, the immune system of the body mistakenly attacks healthy tissue. It c...ImageRead Article Now Book Mark Article Scleroderma SclerodermaScleroderma is a disease that involves the buildup of fibrous tissue in the skin and elsewhere in the body. It also damages the cells that line the ...ImageRead Article Now Book Mark Article Polymyositis PolymyositisPolymyositis and dermatomyositis are rare inflammatory diseases. (The condition is called dermatomyositis when it involves the skin. ) These disease...ImageRead Article Now Book Mark Article Hepatitis C can affect the salivary glands and looks like Sjögren syndrome IgG4 disease can look like Sjögren syndrome and should be considered Symptoms Dry eyes and dry mouth are the most common symptoms of this syndrome.Eye symptoms:Itching eyes Itching eyesEye burning with discharge is burning, itching, or drainage from the eye of any substance other than tears.ImageRead Article Now Book Mark Article Burning sensation in eyes Feeling that something is in the eyeMouth and throat symptoms:Difficulty swallowing or eating dry foods Loss of sense of taste Loss of sense of tasteTaste impairment means there is a problem with your sense of taste. Problems range from distorted taste to a complete loss of the sense of taste. A...Read Article Now Book Mark Article Problems speaking Thick or stringy saliva Mouth sores or pain Teeth decay and gum inflammation HoarsenessHoarsenessHoarseness refers to difficulty making sounds when trying to speak. Vocal sounds may be weak, breathy, scratchy, or husky, and the pitch or quality ...ImageRead Article Now Book Mark Article Other symptoms may include:Fatigue FatigueFatigue is a feeling of weariness, tiredness, or lack of energy.Read Article Now Book Mark Article Fever Change in the color of hands or feet with cold exposure (Raynaud phenomenon) Joint pain or joint swelling Joint painJoint pain can affect one or more joints.ImageRead Article Now Book Mark Article Joint swellingJoint swelling is the buildup of fluid in the soft tissue surrounding the joint or the joint itself.ImageRead Article Now Book Mark Article Swollen glands Swollen glandsLymph nodes are present throughout your body. They are an important part of your immune system. Lymph nodes help your body recognize and fight germ...ImageRead Article Now Book Mark Article Skin rash Numbness and pain due to neuropathy Cough and shortness of breath due to lung disease Irregular heartbeat Nausea and heartburn Vaginal dryness or painful urination Exams and Tests A complete physical exam will be done. The exam reveals dry eyes and dry mouth. There may be mouth sores, decayed teeth or gum inflammation. This occurs because of the mouth dryness. Your health care provider will look in your mouth for fungus infection (candida). Skin may show a rash, the lung exam may be abnormal, the abdomen will be palpated for liver enlargement. The joints will be examined for arthritis. The neurologic exam will look for deficits due to nerve damage.Mouth soresThere are different types of mouth sores. They can occur anywhere in the mouth including bottom of the mouth, inner cheeks, gums, lips, and tongue....ImageRead Article Now Book Mark Article You may have the following tests done:Complete blood chemistry with liver enzymes Complete blood count with differential Urinalysis Antinuclear antibodies (ANA) test AntibodiesAn antibody is a protein produced by the body's immune system when it detects harmful substances, called antigens. Examples of antigens include micr...ImageRead Article Now Book Mark Article ANAThe antinuclear antibody panel is a blood test that looks at antinuclear antibodies (ANA). ANA are antibodies produced by the immune system that bind...ImageRead Article Now Book Mark Article Anti-Ro/SSA and anti-La/SSB antibodies Rheumatoid factor Rheumatoid factorRheumatoid factor (RF) is a blood test that measures the amount of the RF antibody in the blood.ImageRead Article Now Book Mark Article Anti-cyclic citrullinated peptide (CCP) antibody Test for cryoglobulins Complement levels Protein electrophoresis Test for hepatitis C and HIV (if at risk) Thyroid tests Schirmer test of tear production Schirmer testThe Schirmer test determines whether the eye produces enough tears to keep it moist.ImageRead Article Now Book Mark Article Imaging of the salivary gland: by ultrasound or by MRI Salivary gland biopsy Salivary gland biopsySalivary gland biopsy is the removal of cells or a piece of tissue from a salivary gland for exam.ImageRead Article Now Book Mark Article Skin biopsy if a rash is present Examination of the eyes by an ophthalmologist Chest x-ray Treatment The goal is to relieve symptoms.Dry eyes may be treated with artificial tears, eye-lubricating ointments, or cyclosporine liquid. If Candida is present, it may be treated with sugar-free miconazole or nystatin preparations. Tiny plugs can be placed in the tear drainage ducts to help the tears stay on the surface of the eye.Oral medicines such as pilocarpine or cevimeline that cause increased saliva production can be useful in dryness when local therapy is not helping.Disease-modifying antirheumatic drugs (DMARDs) similar to those used for RA may improve the symptoms of Sjögren syndrome. These include Rituximab and tumor necrosis factor (TNF) inhibiting drugs such as etanercept (Enbrel), adalimumab (Humira) or infliximab (Remicade).Some things you can do to ease symptoms include:Sip water throughout the day Chew sugarless gum Avoid medicines that can cause mouth dryness, such as antihistamines and decongestants Avoid alcoholTalk with your dentist about:Mouth rinses to replace minerals in your teeth Saliva substitutes Drugs that help your salivary glands make more salivaTo prevent dental decay caused by mouth dryness:Brush and floss your teeth often Visit the dentist for regular checkups and cleanings Outlook (Prognosis) The disease is most often not life threatening. The outcome depends on what other diseases you have.There is a higher risk for lymphoma and early death when Sjögren syndrome has been very active for a long time, as well as in people with vasculitis, low complements, and cryoglobulins.LymphomaHodgkin lymphoma is a cancer of lymph tissue. Lymph tissue is found in the lymph nodes, spleen, liver, bone marrow, and other sites.ImageRead Article Now Book Mark Article Possible Complications Complications may include:Damage to the eye Dental cavities Kidney failure (rare) Kidney failureAcute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...ImageRead Article Now Book Mark Article Lymphoma Pulmonary disease Vasculitis (rare) Neuropathy Bladder inflammation When to Contact a Medical Professional Contact your provider if you develop symptoms of Sjögren syndrome.Open ReferencesReferencesBaer AN, Verstappen GM. Sjögren syndrome. In: Hochberg MC, Gravallese EM, Smolen JS, van der Heijde D, Weinblatt ME, Weisman MH, eds. Rheumatology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 146.Mariette X, Nocuturne C. Sjogren syndrome. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 252.Seror R, Bootsma H, Saraux A, et al. Defining disease activity states and clinically meaningful improvement in primary Sjögren's syndrome with EULAR primary Sjögren's syndrome disease activity (ESSDAI) and patient-reported indexes (ESSPRI). Ann Rheum Dis. 2016;75(2):382-389. PMID: 25480887 pubmed.ncbi.nlm.nih.gov/25480887/.Singh AG, Singh S, Matteson EL. Rate, risk factors and causes of mortality in patients with Sjögren's syndrome: a systematic review and meta-analysis of cohort studies. Rheumatology (Oxford). 2016;55(3):450-460. PMID: 26412810 pubmed.ncbi.nlm.nih.gov/26412810/.Turner MD. Oral manifestations of systemic diseases. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 12.AllVideoImagesTogAntibodies - illustration Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens. AntibodiesillustrationAntibodies - illustration Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens. AntibodiesillustrationRelated Information Systemic(Special Topic)Autoimmune disorders(Condition)Rheumatoid arthritis(Condition)Systemic lupus erythematosus(Condition)Scleroderma(Condition)Polymyositis - adult(Condition)Acute kidney failure(Condition)Rheumatoid arthritis - InDepth(In-Depth)Systemic lupus erythematosus - InDepth(In-Depth)Scleroderma - InDepth(In-Depth) Review Date: 4/30/2023 Reviewed By: Neil J. Gonter, MD, Assistant Professor of Medicine, Columbia University, New York, NY, and private practice specializing in Rheumatology at Rheumatology Associates of North Jersey, Teaneck, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
Sjogren syndromeXerostomia - Sjögren syndrome; Keratoconjunctivitis sicca - Sjögren; Sicca syndrome; Sjögren syndrome; Sjögren's syndromeSjögren syndrome is an autoimmune disorder in which the glands that produce tears and saliva are destroyed. This causes dry mouth and dry eyes. The condition may affect other parts of the body, including the kidneys and lungs.Autoimmune disorderAn autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 autoimmune d...ImageRead Article Now Book Mark Article Causes The cause of Sjögren syndrome is unknown. It is an autoimmune disorder. This means the body attacks healthy tissue by mistake. The syndrome occurs most often in women ages 40 to 50. It is rare in children.Primary Sjögren syndrome is defined as dry eyes and dry mouth without another autoimmune disorder.Secondary Sjögren syndrome occurs along with another autoimmune disorder, such as:Rheumatoid arthritis (RA) Rheumatoid arthritisRheumatoid arthritis (RA) is a disease that leads to inflammation of the joints and surrounding tissues. It is a long-term disease. It can also aff...ImageRead Article Now Book Mark Article Systemic lupus erythematosus Systemic lupus erythematosusSystemic lupus erythematosus (SLE) is an autoimmune disease. In this disease, the immune system of the body mistakenly attacks healthy tissue. It c...ImageRead Article Now Book Mark Article Scleroderma SclerodermaScleroderma is a disease that involves the buildup of fibrous tissue in the skin and elsewhere in the body. It also damages the cells that line the ...ImageRead Article Now Book Mark Article Polymyositis PolymyositisPolymyositis and dermatomyositis are rare inflammatory diseases. (The condition is called dermatomyositis when it involves the skin. ) These disease...ImageRead Article Now Book Mark Article Hepatitis C can affect the salivary glands and looks like Sjögren syndrome IgG4 disease can look like Sjögren syndrome and should be considered Symptoms Dry eyes and dry mouth are the most common symptoms of this syndrome.Eye symptoms:Itching eyes Itching eyesEye burning with discharge is burning, itching, or drainage from the eye of any substance other than tears.ImageRead Article Now Book Mark Article Burning sensation in eyes Feeling that something is in the eyeMouth and throat symptoms:Difficulty swallowing or eating dry foods Loss of sense of taste Loss of sense of tasteTaste impairment means there is a problem with your sense of taste. Problems range from distorted taste to a complete loss of the sense of taste. A...Read Article Now Book Mark Article Problems speaking Thick or stringy saliva Mouth sores or pain Teeth decay and gum inflammation HoarsenessHoarsenessHoarseness refers to difficulty making sounds when trying to speak. Vocal sounds may be weak, breathy, scratchy, or husky, and the pitch or quality ...ImageRead Article Now Book Mark Article Other symptoms may include:Fatigue FatigueFatigue is a feeling of weariness, tiredness, or lack of energy.Read Article Now Book Mark Article Fever Change in the color of hands or feet with cold exposure (Raynaud phenomenon) Joint pain or joint swelling Joint painJoint pain can affect one or more joints.ImageRead Article Now Book Mark Article Joint swellingJoint swelling is the buildup of fluid in the soft tissue surrounding the joint or the joint itself.ImageRead Article Now Book Mark Article Swollen glands Swollen glandsLymph nodes are present throughout your body. They are an important part of your immune system. Lymph nodes help your body recognize and fight germ...ImageRead Article Now Book Mark Article Skin rash Numbness and pain due to neuropathy Cough and shortness of breath due to lung disease Irregular heartbeat Nausea and heartburn Vaginal dryness or painful urination Exams and Tests A complete physical exam will be done. The exam reveals dry eyes and dry mouth. There may be mouth sores, decayed teeth or gum inflammation. This occurs because of the mouth dryness. Your health care provider will look in your mouth for fungus infection (candida). Skin may show a rash, the lung exam may be abnormal, the abdomen will be palpated for liver enlargement. The joints will be examined for arthritis. The neurologic exam will look for deficits due to nerve damage.Mouth soresThere are different types of mouth sores. They can occur anywhere in the mouth including bottom of the mouth, inner cheeks, gums, lips, and tongue....ImageRead Article Now Book Mark Article You may have the following tests done:Complete blood chemistry with liver enzymes Complete blood count with differential Urinalysis Antinuclear antibodies (ANA) test AntibodiesAn antibody is a protein produced by the body's immune system when it detects harmful substances, called antigens. Examples of antigens include micr...ImageRead Article Now Book Mark Article ANAThe antinuclear antibody panel is a blood test that looks at antinuclear antibodies (ANA). ANA are antibodies produced by the immune system that bind...ImageRead Article Now Book Mark Article Anti-Ro/SSA and anti-La/SSB antibodies Rheumatoid factor Rheumatoid factorRheumatoid factor (RF) is a blood test that measures the amount of the RF antibody in the blood.ImageRead Article Now Book Mark Article Anti-cyclic citrullinated peptide (CCP) antibody Test for cryoglobulins Complement levels Protein electrophoresis Test for hepatitis C and HIV (if at risk) Thyroid tests Schirmer test of tear production Schirmer testThe Schirmer test determines whether the eye produces enough tears to keep it moist.ImageRead Article Now Book Mark Article Imaging of the salivary gland: by ultrasound or by MRI Salivary gland biopsy Salivary gland biopsySalivary gland biopsy is the removal of cells or a piece of tissue from a salivary gland for exam.ImageRead Article Now Book Mark Article Skin biopsy if a rash is present Examination of the eyes by an ophthalmologist Chest x-ray Treatment The goal is to relieve symptoms.Dry eyes may be treated with artificial tears, eye-lubricating ointments, or cyclosporine liquid. If Candida is present, it may be treated with sugar-free miconazole or nystatin preparations. Tiny plugs can be placed in the tear drainage ducts to help the tears stay on the surface of the eye.Oral medicines such as pilocarpine or cevimeline that cause increased saliva production can be useful in dryness when local therapy is not helping.Disease-modifying antirheumatic drugs (DMARDs) similar to those used for RA may improve the symptoms of Sjögren syndrome. These include Rituximab and tumor necrosis factor (TNF) inhibiting drugs such as etanercept (Enbrel), adalimumab (Humira) or infliximab (Remicade).Some things you can do to ease symptoms include:Sip water throughout the day Chew sugarless gum Avoid medicines that can cause mouth dryness, such as antihistamines and decongestants Avoid alcoholTalk with your dentist about:Mouth rinses to replace minerals in your teeth Saliva substitutes Drugs that help your salivary glands make more salivaTo prevent dental decay caused by mouth dryness:Brush and floss your teeth often Visit the dentist for regular checkups and cleanings Outlook (Prognosis) The disease is most often not life threatening. The outcome depends on what other diseases you have.There is a higher risk for lymphoma and early death when Sjögren syndrome has been very active for a long time, as well as in people with vasculitis, low complements, and cryoglobulins.LymphomaHodgkin lymphoma is a cancer of lymph tissue. Lymph tissue is found in the lymph nodes, spleen, liver, bone marrow, and other sites.ImageRead Article Now Book Mark Article Possible Complications Complications may include:Damage to the eye Dental cavities Kidney failure (rare) Kidney failureAcute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...ImageRead Article Now Book Mark Article Lymphoma Pulmonary disease Vasculitis (rare) Neuropathy Bladder inflammation When to Contact a Medical Professional Contact your provider if you develop symptoms of Sjögren syndrome.Open ReferencesReferencesBaer AN, Verstappen GM. Sjögren syndrome. In: Hochberg MC, Gravallese EM, Smolen JS, van der Heijde D, Weinblatt ME, Weisman MH, eds. Rheumatology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 146.Mariette X, Nocuturne C. Sjogren syndrome. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 252.Seror R, Bootsma H, Saraux A, et al. Defining disease activity states and clinically meaningful improvement in primary Sjögren's syndrome with EULAR primary Sjögren's syndrome disease activity (ESSDAI) and patient-reported indexes (ESSPRI). Ann Rheum Dis. 2016;75(2):382-389. PMID: 25480887 pubmed.ncbi.nlm.nih.gov/25480887/.Singh AG, Singh S, Matteson EL. Rate, risk factors and causes of mortality in patients with Sjögren's syndrome: a systematic review and meta-analysis of cohort studies. Rheumatology (Oxford). 2016;55(3):450-460. PMID: 26412810 pubmed.ncbi.nlm.nih.gov/26412810/.Turner MD. Oral manifestations of systemic diseases. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 12.