Sjögren's Syndrome

Symptoms

The most common symptoms of Sjögren's syndrome are extremely dry eyes and mouth that have lasted for at least 3 months and are not due to medicines. You may have itching and burning in your eyes, and your mouth may feel as though it is full of cotton.

Dry eyes and dry mouth (sicca syndrome)

Dry eyes:	Dry mouth:
Dry, gritty, sandy, or itchy feeling in your eyes Thick, ropelike strands of dried mucus in your eyes when you wake up Redness and less tearing A "filmy" feeling in your eyes that interferes with vision Bright lights may bother your eyes Inflamed eyelids (blepharitis) Eye fatigue	Less saliva than usual Trouble swallowing food without also drinking a liquid Abnormal sense of taste Sores (fissures) on the tongue and lips Many cavities and gum disease caused by rapid tooth decay Decreased sense of taste and smell Mouth may feel full of cotton

People with Sjögren's syndrome may also notice:

• Dry nose and throat, which can lead to sinus infections, bronchitis, and pneumonia.
• Skin problems such as rashes that may be sensitive to light, or dry skin with less sweat production.
• Yeast infections of the mouth (thrush) or skin.
• Vaginal dryness, causing discomfort, itching, and painful intercourse.
• Fatigue and joint or muscle pain.
• Pain and difficulty with dentures, which may lead to dental restorations.
• Cold, numb, painful fingers and hands (Raynaud's phenomenon).

Sjögren's syndrome may develop in a person who has a connective tissue disorder, such as rheumatoid arthritis, lupus, or scleroderma. In these cases, it is called secondary Sjögren's syndrome. Symptoms of primary (no associated disorder) and secondary Sjögren's syndrome are the same. But it may be difficult to tell the difference between symptoms caused by secondary Sjögren's syndrome and those caused by another connective tissue disorder.

If you have symptoms other than or along with those identified, it is possible you may have another autoimmune disease in addition to Sjögren's syndrome. Discuss all of your symptoms with your doctor so that you can be accurately diagnosed.

Progression of Sjögren's syndrome varies by individual. Some people develop symptoms in other parts of the body, while about 12% spontaneously improve. Most people with Sjögren's syndrome have chronic dryness of the eyes and mouth that stays with them throughout their lives.¹

While not common, serious complications involving major body organs (such as the lungs, nerves, kidneys, and liver) may develop as the disease progresses. A small percentage of people with Sjögren's have a slightly higher chance of developing cancer involving the lymphatic system, such as non-Hodgkin's lymphoma.²

There are many other conditions with similar symptoms. Your doctor will review your symptoms and do laboratory tests to confirm a diagnosis of Sjögren's syndrome.

Who to See

Sjögren's syndrome can affect many different body systems. Doctors in several specialties can diagnose this disorder. Depending on your symptoms, you may want to work with several doctors:

• Rheumatologist
• Ophthalmologist
• Dentist
• Internist or family medicine doctor

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Author:	Shannon Erstad, MBA/MPH	Last Updated: May 6, 2008
Medical Review:	Martin Gabica, MD - Family Medicine Stanford M. Shoor, MD - Rheumatology
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