Sjogren's syndrome is a common, chronic, autoimmune disease chiefly causing dryness of the mucous membranes. Although different parts of the body can be affected, the disease primarily involves the tear and salivary glands. Ten times as many women as men are diagnosed with the illness, which occurs most often in middle age. Sjorgren's syndrome is classified as primary when there is no pre-existing rheumatologic disease. About 30 percent of those affected have an associated autoimmune illness, and are thus classified as having secondary Sjogren's syndrome. The cause is unknown.
General
Sjogren's effects are characterized by white blood cell infiltration into mucous membranes and other body tissues. Though predominately involving dryness of the eyes and mouth, Sjogren's syndrome can also cause dryness in the nose, throat, lungs, skin and vagina. Multiple body systems may be involved, including respiratory, gastrointestinal, renal, hepatobiliary and central nervous system. The disease fluctuates between states of remission and relapse over many years and even decades.
Eye Symptoms
Sjogren's syndrome causes oxidative injury to the surface of the eye; an important pathological factor influencing symptoms of dryness and a gritty, sandy sensation. In a paper from the journal Histology and Histopathology, the authors discuss the processes relating to toxic inflammatory substances present in the lacrimal fluid of Sjogren's syndrome patients. Decreased antioxidants and an increase in inflammatory products are directly correlated with the severity of dry eye symptoms.
Oral Symptoms
Inflammatory cytokines lead to damage of the salivary ducts and eventual atrophy. The ensuing severe dryness of the mouth and lips may interfere with chewing and swallowing and can promote tooth decay. Sjogren's syndrome sometimes leads to periodontal disease and loss of teeth. There can also be a diminished or lost sense of taste and smell. Approximately one-third of people with Sjogren's syndrome develop enlarged parotid glands, though this is rarely painful.
Extraglandular Disease
Nearly half of Sjogren's patients develop illness in tissue other than the exocrine glands. Raynaud's syndrome and other rheumatic diseases may manifest. Arthralgias and nonerosive and nondeforming arthritis often occur. Additionally, swollen lymph nodes, pancreatitis, vasculitis, peripheral neuropathy, lung, liver and kidney involvement can arise. Sjogren's syndrome patients are also at increased risk for lymphoma and Waldenstrom's macroglobulinemia.
Prognosis
The outlook for Sjogren's patients is generally very good. The majority of those with the illness can be effectively treated and will experience only minor, if any, complications. Although unusual, severe symptoms or death can result from lung infection or lymphoma.
