In the early 20th century, Swedish physician Henrik Sjögren (SHOW-gren) first described a group of women whose chronic arthritis was accompanied by dry eyes and dry mouth. Patients complain of irritation, a gritty feeling or painful burning in the eyes. Eyelids may stick together and patients may complain of mouth dryness. Food is difficult to chew and swallow. About half of Sjögren's syndrome patients also have rheumatoid arthritis or other connective tissue disease.
Sjögren's syndrome is a disorder of the immune system, which normally functions to protect the body against cancers and invading infections. The several factors involved include genetic, immunologic, hormonal, and probably infectious. People with this disease have abnormal proteins in their blood that suggest that their immune system is reacting against their own tissue. The decreased production of tears and saliva is caused when the glands that produce these fluids are damaged. These glands are attacked by immune cells called lymphocytes. In a small number of people, Sjögren's syndrome is associated with lymphoma, a form of cancer.
Sjögren's syndrome is diagnosed by blood tests, a decrease in tear and saliva production, X-rays of salivary glands, and lip biopsy.
Treatment depends on symptoms. No treatment, however, has yet been found to restore glandular secretions. Ocular dryness responds to the use of artificial tears applied every one to three hours. Dry mouth can be relieved by drinking water, chewing gum, or using saliva stimulants (such as pilocarpine). For life threatening complications, medications such as corticosteroids and cyclophosphamide are occasionally needed.
Rheumatologists, the leading researchers in Sjögren's syndrome, are seeking to determine the cause and cure of this disorder and other rheumatic diseases.
