Q. What is Sjögren’s?
A. Sjögren’s is a chronic autoimmune disease in which a person’s white blood cells attack his or her moisture-producing glands. Today, as many as four million Americans are living with this disease. Learn more at our About Sjögren’s Syndrome page.
Q. Who is most likely to develop Sjögren’s?
A. Nine out of ten Sjögren’s patients are women. The average age of diagnosis is late 40s, although it can occur in all age groups, including children, and in both sexes.
Q. What are the symptoms of Sjögren’s?
A. The most common symptoms include dry eyes, dry mouth, fatigue and musculoskeletal pain. However, no two people have the exact same set of symptoms so patients should remember to share all their symptoms with their primary healthcare provider to receive a proper diagnosis. See the website’s symptoms page for a full list of Sjogren's syndrome symptoms.
Q. Is it easy to diagnose Sjögren’s?
A. Sjögren’s often is undiagnosed or misdiagnosed. The symptoms of Sjögren’s may mimic those of menopause, drug side effects, allergies, or medical conditions such as lupus, rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome, and multiple sclerosis. Because all symptoms are not always present at the same time and because Sjögren’s can involve several body systems, physicians, eye care providers and dentists sometimes treat each symptom individually and do not recognize that a systemic disease is present. The average time from onset of symptoms to diagnosis is 4.7 years.
Q. How is Sjögren’s formally diagnosed?
A. Sjögren’s can be difficult to diagnose. No single test will confirm the diagnosis and Sjögren’s may appear in many different forms in different patients. Click here to view our page on diagnosing Sjögren’s syndrome.
Q. What kind of doctor treats Sjögren’s?
A. Rheumatologists have primary responsibility for managing Sjögren’s. Patients are also seen and treated by specialists such as eye care providers, dentists and other specialists depending on a patient’s complications.
Q. Is there a cure? What treatments are available?
A. Currently, there is no cure for Sjögren’s. However, treatments may improve various symptoms and prevent complications. Prescription medicines for dry eyes and dry mouth are available. A number of over-the-counter products may also be used to alleviate different types of dryness. Immunosuppressive medications are also used to treat the serious internal organ manifestations.
Q. What is the difference between Primary Sjögren’s versus Secondary Sjögren’s?
A. Sjögren’s is usually classified by a clinician as either primary or secondary. Primary Sjögren’s occurs by itself and secondary Sjögren’s occurs when another connective tissue disease is present. However, this classification does not always correlate with the severity of symptoms or complications. Primary Sjögren’s and Secondary Sjögren’s patients can all experience the same level of discomfort, complications and seriousness of their disease.
Q. Will I die from Sjögren’s?
A. Sjögren’s is serious but generally not fatal if complications are diagnosed and treated early. Sjögren’s syndrome patients must be monitored carefully for development of internal organ involvement, related autoimmune diseases and other serious complications. In particular, patients should be aware that the incidence of lymphomas (cancer of the lymph nodes) is significantly higher in people with Sjögren’s compared to the general population.
Q. What causes the dryness in Sjögren’s?
A. In the autommune attack that causes Sjögren’s, disease-fighting white blood cells called lymphocytes target the glands that produce moisture – primarily the lacrimal (tear) and salivary (saliva) glands. Although no one knows exactly how damage occurs, damaged glands can no longer produce tears and saliva, and eye and mouth dryness result. When the skin, sinuses, airways and vaginal tissues are affected, dryness occurs in those places as well.
Q. What research is being done on Sjögren’s?
A. Through basic research on the immune system, autoimmunity, genetics and connective tissue diseases, researchers are continuing to learn more about Sjögren’s syndrome. As they gain a better understanding of the genes involved and which environmental and hormonal factors trigger the disease, we will be able to develop more effective treatments for Sjögren’s.
In addition, clinical research is being conducted around the United States. These research projects involve studying patients in a clinical setting to learn more about their symptoms, what treatments work and under what circumstances, and how best to improve quality of life.
Q. Do you recommend flu vaccine for Sjögren's patients?
I recommend that most of my patients with Sjögren’s syndrome get a flu shot unless they are allergic to eggs, have had a reaction to the vaccine previously, or have other health issues that are a contraindication to the vaccination. But it is always best to discuss the vaccination with your physician.
The side-effects of the vaccine, including achiness at the injection site and very mild flu-like symptoms, are certainly an inconvenience. But contracting the influenza virus could cause severe and even life-threatening symptoms for someone with an autoimmune disease. It could lead to a severe febrile respiratory illness that may mean significant time away from work and possibly hospitalization.
I prefer that my patients receive the vaccine in shot form rather than the nasal spray. The shot is inactivated virus particles, while the nasal form is live virus, so there is more risk of developing mild viral symptoms with the nasal administration. This risk associated with the nasal spray vaccination is higher if you are taking medications that can affect the immune system, such as azathioprine, methotrexate, or prednisone. Even still, most patients with Sjögren’s who take systemic medications may receive a flu vaccination, but, again, it is always best to discuss this with your physician before taking the injection.
- Jody K. Hargrove, MD