Sjogren's Syndrome: Symptoms and Diagnosis
What are common symptoms of Sjögren's syndrome?
- Dry eyes: Daily persistent dry eye (may feel gritty/sandy) and may need to use eye drops regularly
- Dry mouth: Daily persistent dry mouth. May need to wake up at nighttime to drink fluids and requiring sips of liquid to swallow dry foods
- Cavities: Recurrent cavities despite taking care of your teeth and visiting the dentist
- Thrush: A white plaque or redness of the tongue that can cause burning or change in taste
- Gland swelling: Swelling of the glands in your face and neck
- Other symptoms may depend upon what organs have been involved (i.e. lungs, kidney, liver, nerves, etc.)
Why do people develop Sjögren's syndrome?
The exact cause of Sjögren's syndrome is unknown. Doctors believe that a combination of genetic and environmental factors lead to the development of Sjögren's syndrome. The exact environmental factors that trigger Sjögren's syndrome are also unknown, but might include infection, such as viruses or bacteria, or hormones.
How is Sjögren's syndrome diagnosed?
Doctors commonly diagnose Sjögren's syndrome using the following measures:
- Measurement of tear and saliva production
- The presence of specific antibodies that can be seen in Sjögren's syndrome (anti-SSA/Ro antibody)
- Inflammation of the glands of the lower lip
- Minor Salivary Gland Biopsy (Note: Content includes medical photographs of biopsy procedure)
How can I prepare for my visit?
- Be prepared to discuss your symptoms, past medical history, past surgical history and current medications (including over-the-counter medicines)
- You might be asked about a history of head/neck radiation, hepatitis C, HIV, cancer or cataract/eye surgery
- Do not eat or drink anything on the morning of your first visit because your doctor may order/perform tests requiring that you have not eaten
- If you are taking treatment for dry eye (eye drops) or mouth (things to make more saliva), stop the week before your visit
What should I expect at my visit?
- Your doctor might perform a test to measure eye wetness. This is called a Schirmer's test. You might need to visit an eye doctor for further specialized dry eye testing.
- Your doctor might perform a test to measure saliva production. This is called a salivary flow test.
- Blood Tests: Measures of blood counts, Sjögren's-related antibodies, blood proteins, kidney and liver tests and evidence of other diseases of the immune systems.
- Imaging: You may be given an ultrasound, a sialogram (a type of X-ray) or an MRI to look at the glands of your head and neck.
- Minor Salivary Gland Biopsy: Your doctor might want to perform a biopsy of your lip to obtain minor salivary glands. These glands are evaluated through a microscope to assess for inflammation. The minor salivary gland can be used as part of the diagnosis of Sjögren's syndrome and can also be used as a tool to predict how severe the Sjögren's syndrome may become in an individual patient.
How is Sjögren's Syndrome treated?
Treatment of Sjögren's syndrome is primarily targeted at improving symptoms of dry eye and dry mouth. Various treatment modalities, including the use of barriers, wetting agents and prescription medications, might be used.