This is a disease where the immune cells of the body attack one’s own exocrine glands – especially those that produce tears and saliva.

It is classified as a systemic autoimmune disease.

This disease is often seen in women – almost 90% of the time.

Disease often has an onset age of over 40.

The disease can affect any men and women of any age.

More than 4 million Americans are effected by this disease.

Types:

1.)  Primary Sjogren’s syndrome

2.)  Secondary

-  Can be a secondary disease, years after onset of another associated rheumatic disorder such as: Rheumatoid Arthritis, Lupus Erythematosus, Scleroderma, Biliary cirrhosis, others.

Symptoms

-  Can be difficult – a wide variety of symptoms can be seen
-  Generalized Dizziness – Hallmark
-  Dry mouth
-  Dry cough
-  Dry eyes
-  Skin dryness
-  Rash
-  Nose dryness
-  Vaginal dryness
-  Organ involvement with possible damage: Lungs, Liver, Kidney, Blood vessels, Pancreas, and others
-  Fatigue
-  Swollen salivary glands
-  Joint pain

Diagnosis

Cerebrospinal fluid

- An elevated IL-IRA  (Interleukin-1 receptor antagonist) which may be a marker for fatigue.

Blood work

- Increased levels of ANA (anti-nuclear antibody) and rheumatoid factor can be seen – both are associated with autoimmune diseases

Schirmer test

- Measures the production of tears
- A strip of filter paper is placed inside the lower eyelid for a 5 minute period.
- When a low amount is analyzed – often is indicative of Sjogren’s syndrome.

Ultrasound

- Examination of salivary glands – simplest confirmatory test.
- Small lesions in the gland will be seen.
- Stones inside salivary gland can be seen.  (Sialectasis)

Treatment

No known cure

Goal is to control inflammation process of this disease and to improve symptoms.

.       Artificial tears
.       Ciclosporin – [Restasis] – medication to help treat dry eye
.       Cebimeline – [Evoxac] – medication to help stimulate salivary flow
.       Pilocarpine   -  helps stimulate salivary flow

.       NSAID  -  Help with pain in joints and musculoskeletal symptoms

.       Steroids [corticosteroids] – treat advance cases/symptoms
.       Immunosuppressive drugs -  treat advance cases/symptoms

.       Methotrexate
.       Hydroxychloroquine  [Plaquenil]   -  Disease modifying anti-rheumatic agents (DMARDs)

.       Others