Sjögren's Syndrome and Lupus

Description of Sjögren's Syndrome

Sjögren's syndrome can occur:

• alone OR
• in association with other autoimmune diseases, most commonly systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA).

Several studies have shown various differences between people with Sjogren's syndrome alone and those with Sjögren's syndrome and another connective tissue disease. Because of these differences:

1. Sjögren's syndrome is termed primary Sjogren's syndrome when it occurs by itself.
2. When associated with another connective tissue disease, such as SLE or RA, it is termed secondary Sjögren's syndrome.

The diagnostic criteria for Sjögren's syndrome include:

• dry mouth
• poor salivary (saliva producing) gland production
• dry eyes
• often the presence of antinuclear antibodies
• the presence of a positive rheumatoid factor.

Because the disease is mild in many people, the first signs of mucosal dryness may be present for years before the disease becomes clearly evident.

Symptoms of Sjögren's Syndrome

Mouth

The symptom most associated with Sjögren's syndrome is oral (mouth) dryness, known as xerostomia.

Other oral symptoms that may be present include:

• burning of the tongue
• cracking of the tongue
• increased dental caries (cavities)
• trouble swallowing
• difficulty speaking without the use of continued lubrication.

Fluid intake is often necessary both with and between meals because of the decrease in salivary gland secretion.

The parotid glands (major salivary glands located behind the jaw) may be enlarged and painful swelling may also be noted.

• Enlargement of parotid or other major salivary glands occurs in two-thirds of those with primary Sjögren's syndrome
• Enlargement of the parotid and other glands is uncommon in those with secondary Sjögren's syndrome.