Pregnancy SmartSite^TM

• Home
• Email
• Site Map
• Contact

• Normal Pregnancy
• Labor & Delivery
• Complications
• After Your Child Is Born

Normal Pregnancy

Staying Healthy

Alcohol and pregnancy Managing your weight gain in pregnancy Steps to take before you get pregnant When you need to gain more weight during pregnancy

What to expect during pregnancy

Aches and pains during pregnancy Choosing the right practitioner Common symptoms during pregnancy Hyperemesis Gravidarum Morning sickness Pregnancy and travel Pregnancy and work Problems sleeping during pregnancy Skin and hair changes during pregnancy Teenage pregnancy

Preparing to go home with your baby

Cribs and crib safety Eat right during pregnancy Preparing your other children

Visits and Tests

Amniocentesis Chorionic villus sampling Genetic counseling before pregnancy Glucose tolerance test-pregnancy Monitoring your baby before labor Nuchal translucency Prenatal care in your first trimester Prenatal care in your second trimester Prenatal care in your third trimester

Sjogren syndrome

Definition

Sjögren syndrome is an autoimmune disorder in which the glands that produce tears and saliva are destroyed. This causes dry mouth and dry eyes. The condition may affect other parts of the body, including the kidneys and lungs.

Causes

The cause of Sjögren syndrome is unknown. It is an autoimmune disorder. This means the body attacks healthy tissue by mistake. The syndrome occurs most often in women ages 40 to 50. It is rare in children.

Primary Sjögren syndrome is defined as dry eyes and dry mouth without another autoimmune disorder.

Secondary Sjögren syndrome occurs along with another autoimmune disorder, such as:

• Rheumatoid arthritis (RA)

• Systemic lupus erythematosus

• Scleroderma

• Polymyositis

• Hepatitis C (can affect the salivary glands and look like Sjögren syndrome)

• IgG4 disease (can look like Sjögren syndrome)

Symptoms

Dry eyes and dry mouth are the most common symptoms of this syndrome.

Eye symptoms:

• Itching eyes

• Burning sensation in eyes

• Feeling that something is in the eye

Mouth and throat symptoms:

• Difficulty swallowing or eating dry foods

• Loss of sense of taste

• Problems speaking

• Thick or stringy saliva

• Mouth sores or pain

• Teeth decay and gum inflammation

• Hoarseness

Other symptoms may include:

• Fatigue

• Fever

• Change in the color of hands or feet with cold exposure (Raynaud phenomenon)

• Joint pain or joint swelling

• Swollen glands

• Skin rash

• Numbness and pain due to neuropathy

• Cough and shortness of breath due to lung disease

• Irregular heartbeat

• Nausea and heartburn

• Vaginal dryness or painful urination

Exams and Tests

A complete physical exam will be done. The exam reveals dry eyes and dry mouth. There may be mouth sores, decayed teeth or gum inflammation. This occurs because of the mouth dryness. Your health care provider will look in your mouth for fungus infection (candida). Skin may show a rash, the lung exam may be abnormal, the abdomen will be palpated for liver enlargement. The joints will be examined for arthritis. The neurologic exam will look for deficits due to nerve damage.

You may have the following tests done:

• Complete blood chemistry with liver enzymes

• Complete blood count with differential

• Urinalysis

• Antinuclear antibodies (ANA) test

• Anti-Ro/SSA and anti-La/SSB antibodies

• Rheumatoid factor

• Anti-cyclic citrullinated peptide (CCP) antibody

• Test for cryoglobulins

• Complement levels

• Protein electrophoresis (serum or urine)

• Test for hepatitis C and HIV (if at risk)

• Thyroid tests

• Schirmer test of tear production

• Imaging of the salivary gland: by ultrasound or by MRI

• Salivary gland biopsy

• Skin biopsy if a rash is present

• Examination of the eyes by an ophthalmologist

• Chest x-ray

Treatment

The goal is to relieve symptoms.

• Dry eyes may be treated with artificial tears, eye-lubricating ointments, or cyclosporine liquid.

• If Candida is present, it may be treated with sugar-free miconazole or nystatin preparations.

• Tiny plugs can be placed in the tear drainage ducts to help the tears stay on the surface of the eye.

Oral medicines such as pilocarpine or cevimeline that cause increased saliva production can be useful in dryness when local therapy is not helping.

Disease-modifying antirheumatic drugs (DMARDs) similar to those used for RA may improve the symptoms of Sjögren syndrome. These include Rituximab and tumor necrosis factor (TNF) inhibiting drugs such as etanercept (Enbrel), adalimumab (Humira) or infliximab (Remicade).

Some things you can do to ease symptoms include:

• Sip water throughout the day

• Chew sugarless gum

• Avoid medicines that can cause mouth dryness, such as antihistamines and decongestants

• Avoid alcohol

Talk with your dentist about:

• Mouth rinses to replace minerals in your teeth

• Saliva substitutes

• Medicines that help your salivary glands make more saliva

To prevent dental decay caused by mouth dryness:

• Brush and floss your teeth often

• Visit the dentist for regular checkups and cleanings

Outlook (Prognosis)

The disease is most often not life threatening. The outcome depends on what other diseases you have.

There is a higher risk for lymphoma and early death when Sjögren syndrome has been very active for a long time, as well as in people with vasculitis, low complements, and cryoglobulins.

Possible Complications

Complications may include:

• Damage to the eye

• Dental cavities

• Kidney failure (rare)

• Lymphoma

• Pulmonary disease

• Vasculitis (rare)

• Neuropathy

• Bladder inflammation

When to Contact a Medical Professional

Contact your provider if you develop symptoms of Sjögren syndrome.

References

Pang R, Ma X, Guo H, Qi X. Meta-analysis of mortality-associated factors in primary Sjögren's syndrome patients with interstitial lung disease. Clin Rheumatol. 2025;44(1):23-31. PMID: 39432139 pubmed.ncbi.nlm.nih.gov/39432139/.

St. Clair EW. Sjögren syndrome. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 247.

St. Clair EW, Leverenz DL. Sjögren syndrome. In: Firestein GS, McInnes IB, Koretzky GA, Mikuls TR, Neogi T, O'Dell JR, eds. Firestein & Kelley's Textbook of Rheumatology. 12th ed. Philadelphia, PA: Elsevier; 2025:chap 74.

Turner MD. Oral manifestations of systemic diseases. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 12.

Review Date: 4/1/2025

Reviewed By: Diane M. Horowitz, MD, Rheumatology and Internal Medicine, Northwell Health, Great Neck, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.