Medical History and Physical Exam
Your provider will review your symptoms, medical history, and any existing autoimmune conditions. A physical exam may include checking for swollen salivary glands and signs of dryness in the eyes and mouth.
What is Sjogren’s Syndrome?
Sjogren’s syndrome is a chronic autoimmune condition in which the immune system mistakenly attacks the glands that produce moisture, particularly the salivary glands and tear glands. This leads to the hallmark symptoms of the condition: persistent dry eyes and dry mouth.
Sjogren’s can occur on its own, known as primary Sjogren’s syndrome, or alongside other autoimmune conditions such as rheumatoid arthritis or lupus, which is referred to as secondary Sjogren’s syndrome. While the condition can develop at any age, it is most commonly diagnosed in adults over 40, and women are affected approximately nine times more often than men.
Although Sjogren’s syndrome is best known for its effects on the eyes and mouth, it is a systemic condition that can affect many parts of the body. Early diagnosis and ongoing management with a rheumatologist can help relieve symptoms and reduce the risk of complications.
Primary vs. Secondary Sjogren’s Syndrome
Sjogren’s syndrome is classified into two types based on whether it occurs alone or alongside another autoimmune condition.
Primary Sjogren’s syndrome develops on its own, without the presence of another autoimmune disease. People with primary Sjogren’s may experience a wider range of systemic symptoms, as the condition is not overshadowed by another diagnosis.
Secondary Sjogren’s syndrome occurs in people who already have another autoimmune condition, most commonly rheumatoid arthritis, lupus, or scleroderma. In these cases, Sjogren’s symptoms may overlap with or be mistaken for symptoms of the primary condition, which can delay diagnosis.
Both types cause similar symptoms and require ongoing management. Understanding which type you have helps your rheumatologist tailor your treatment plan and monitor for condition-specific complications.
Who is at Risk for Sjogren’s Syndrome?
The exact cause of Sjogren’s syndrome is not fully understood, but researchers believe a combination of genetic, environmental, and hormonal factors may contribute to its development:
- Sex – Women are significantly more likely to develop Sjogren’s syndrome than men
- Age – The condition is most commonly diagnosed in people over 40
- Other autoimmune conditions – Having rheumatoid arthritis, lupus, or scleroderma increases the likelihood of developing Sjogren’s
- Family history – People with relatives who have Sjogren’s or other autoimmune diseases may have a higher risk
- Viral infections – Some research suggests that certain viral infections may trigger the condition in people who are genetically predisposed
Symptoms of Sjogren’s Syndrome
Sjogren’s syndrome symptoms can vary widely from person to person. Some people experience only mild discomfort, while others have symptoms that significantly affect daily life.
Primary symptoms include:
- Dry eyes that may burn, itch, or feel gritty
- Dry mouth that makes it difficult to swallow, speak, or taste food
- Swollen salivary glands, particularly along the jaw and in front of the ears
- Increased dental cavities or oral infections due to reduced saliva
- Dry or cracked lips and dry, irritated throat
Sjogren’s can also cause symptoms throughout the body:
- Fatigue, which is one of the most common and disabling symptoms
- Joint pain and stiffness
- Dry skin and skin rashes
- Persistent dry cough
- Numbness or tingling in the hands and feet (peripheral neuropathy)
Symptoms often develop gradually and may be mistaken for other conditions or attributed to aging, which can delay diagnosis. If you experience persistent dryness along with fatigue or joint pain, consult a rheumatologist for evaluation.
Complications of Sjogren's Syndrome
How is Sjogren's Syndrome Diagnosed?
Sjogren’s syndrome can be challenging to diagnose because its symptoms overlap with many other conditions. Your rheumatologist will use a combination of clinical evaluation, lab tests, and specialized assessments to reach an accurate diagnosis.
Blood Tests
Several blood tests can help support a Sjogren’s diagnosis:
- ANA (antinuclear antibodies) – often elevated in autoimmune conditions
- SSA (anti-Ro) and SSB (anti-La) antibodies – specific markers associated with Sjogren’s syndrome
- Rheumatoid factor – may be present in people with Sjogren’s
- Inflammatory markers (ESR and CRP) – can indicate ongoing inflammation
Eye Tests
A Schirmer test measures tear production by placing a small strip of paper under the lower eyelid. Your provider or an ophthalmologist may also use special dyes to examine the surface of your eyes for damage caused by dryness.
Salivary Gland Evaluation
Salivary gland function can be assessed through imaging, measuring saliva flow, or in some cases, a minor salivary gland biopsy. During a biopsy, a small sample of tissue is taken from the inner lip and examined for the characteristic inflammatory patterns seen in Sjogren’s syndrome.
Treatment Options for Sjogren's Syndrome
There is no cure for Sjogren’s syndrome, but a variety of treatments can help manage symptoms and prevent complications. Your rheumatologist will develop a personalized treatment plan based on which parts of your body are affected and the severity of your symptoms.
Managing Dry Eyes
Managing Dry Mouth
Systemic Treatments
Lifestyle Modifications
When to See a Specialist
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