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A
Achlorhydria

Gastric acid deficiency.

Acini

One of the small sac-like dilations composing a compound gland.

ACR (American College of Rheumatology)

A professional association of United States rheumatologists. Criteria (definitions) of many rheumatic diseases are called the ACR Criteria.

Acupuncture

The procedure of inserting and manipulating needles into various points on the body to relieve pain or for therapeutic purposes.

Adaptive Immunity

Normally is functionally triggered after activation of the innate immunity system by foreign pathogens.

Adenopathy

A swelling of the lymph nodes. In Sjögren's, this usually occurs in the neck and jaw region.

Albumin

A protein that circulates in the blood and carries materials to cells. Decreased in chronic disease.

Allodynia

Pain due to a stimulus which does not normally produce pain.

Alopecia

Hair loss.

Alveoli

Small air sacs in the bronchi of the lungs.

Amylase

An enzyme present in saliva; another form of amylase is produced by the pancreas. 

Analgesic

A drug that alleviates pain.

Androgen

A steroid hormone produced from cholesterol in the adrenal cortex, which is the primary precursor of natural estrogens.

Anemia

Low numbers of red blood cells.

Angular Cheilitis

Sores at the corners of the mouth (angles of the lips).

Anhedonia

Loss of interest or pleasure in doing things.

Anosmia

Loss of smell.

Anti-Cholinergic

A class of medications that inhibit parasympathetic nerve impulses by selectively blocking the binding of the neurotransmitter acetylcholine to its receptor in nerve cells. A variety of these medications have side effects with resulting dry eyes and dry mouth.

Anti-DNA (anti-double-stranded DNA)

Antibodies to DNA; seen in half of patients with Lupus.

Anti-ENA (extractable nuclear antibodies)

A group of antibodies that includes anti-Sm and anti-RNP.

Anti-Muscarinic Receptor Antibody

This antibody is thought to block the action of the nerves that go to the salivary and lacrimal glands, thereby reducing the production of saliva and tears.

Anti-RNP

Antibody to ribonucleoprotein. Seen in lupus and mixed connective tissue disease.

Anti-Sm

Anti-Smith antibody; found only in lupus.

Anti-SSA (Ro antibody)

Associated with Sjögren’s, sun sensitivity, neonatal lupus, and congenital heart block.

Anti-SSB (La antibody)

Almost always seen with anti-SSA.

Antibody

Substance in the blood that is normally made in response to infection. Also referred to as immunoglobulins such as IgG, IgM, etc.

Anticardiolipin Antibody

An antiphospholipid antibody.

Anticentromere Antibody

Antibodies to a cell nucleus associated with scleroderma.

Antigen(s)

A chemical substance that provokes the production of antibody. In tetanus vaccination, for example, tetanus is the antigen injected to produce antibodies and hence protective immunity to tetanus.

Antimalarial Drugs

Quinine derived drugs, which were first developed to treat malaria and can manage Sjögren's such as hydroxychloroquine (Plaquenil).

Antimitochondrial Antibodies (AMA)

Antibodies (immunoglobulins) formed against mitochondria, primarily mitochondria in cells of the liver found in Sjögren's patients with biliary cirrhosis.

Antinuclear Antibodies (ANA)

Autoantibodies directed against components in the nucleus of the cell. Screening test for lupus and other connective tissue diseases including Sjögren's.

Antiphospholipid Antibody

Antibodies to a constituent of cell membranes seen in one-third of those with SLE. In the presence of a cofactor, these antibodies can alter clotting and lead to strokes, blood clots, miscarriages, and low platelet counts. Also detected as the lupus anticoagulant.

Antiphospholipid Antibody

Antibodies to a constituent of cell membranes seen in one-third of those with SLE. In the presence of a cofactor, these antibodies can alter clotting and lead to strokes, blood clots, miscarriages, and low platelet counts. Also detected as the lupus anticoagulant.

Antiphospholipid Antibody Syndrome (APS)

Thromboembolic events in a patient with antiphospholipid antibody.

Antispasmodic Drugs

Medications that quiet spasms. Usually used in reference to the gastrointestinal tract.

Apoptosis

Programmed cell death.

Aqueous Deficient Dry Eye

Disruption of the tear film either because of inadequate secretion of tears arteries become swollen and damaged.

Arachadonic Acid

An unsaturated fatty acid found in animal fats that is essential in human nutrition and is a precursor in the biosynthesis of some prostaglandins.

Arteriole

A very small artery.

Arthralgia

Pain in a joint.

Arthritis

Inflammation of a join.

Ascites

An abnormal fluid that collects in the abdomen due to certain liver and other disorders.

Atelectasis

A collapse of lung tissue affecting part or all of one lung.

Atrophic Rhinitis

Autoimmune destruction of acid producing parietal cells of the stomach.  May lead to  vitamin B12 deficiency and pernicious anemia.  Up to 20% of SS patients may have antibodies against parietal cells.

Atrophic Vaginitis

A condition characterized by dryness and inflammation of the vagina with thinning of the epithelial lining due to estrogen deficiency.

Atrophy

A thinning of the surface; a form of wasting.

Atrophy

A thinning of the surface; a form of wasting.

Autoantibody

Antibody that attacks the body's own tissues and organs as if they were foreign.

Autoimmune Hepatitis

Inflammation of the liver that occurs when immune cells mistake the liver's normal cells for harmful invaders and attack them.

Autoimmune Pancreatitis

An increasingly recognized type of chronic pancreatitis that can be difficult to distinguish from pancreatic carcinoma but which responds to treatment with corticosteroids, particularly prednisone. Rare complication of Sjögren's.

Autoimmune Thyroiditis

Disease of the thyroid gland due to autoimmunity in which the patient's immune system attacks and damages their thyroid.

Autoimmunity

A state in which the body inappropriately produces antibody against its own tissues. The antigens are components of the body.

Autonomic Neuropathy

Nerve damage that affects the autonomic nervous system, which controls digestive, bladder, bowel, cardiac, and sexual function.

B
B Cell or B lymphocyte

A white blood cell that makes antibodies.

B Cell or B Lymphocyte

A white blood cell that makes antibodies.

BAFF (B cell Activating Factor of the TNF Family), also called BLyS

A powerful driver of B cell development.

Basal (Resting) Rate

Unstimulated (used in reference to both tears and salivary flow).

Biologic Therapies

Treatment to stimulate or restore the ability of the immune (defense) system to fight infection and disease.

Blepharitis

Common, persistent and sometimes chronic inflammation of the eyelids, resulting from bacteria that reside on the skin.

Bolus

A morsel of food, already chewed, ready to be swallowed.

Brain fog

Impaired concentration and memory that can be due to various causes.

Bronchi

Branches of the trachea.

Buffer

A mixture of acid or base that, when added to a solution, enables the solution to resist changes in the pH that would otherwise occur when acid or alkali is added to it.

C
C-Reactive Protein (CRP)

The test measures systemic inflammation. Produced by the liver. The level of CRP rises when there is inflammation throughout the body.

Calcification

A process in which tissue or noncellular material in the body becomes hardened as the result of deposits of insoluble calcium salts.

Candida

A yeast-like fungal organism.

Candidiasis

A condition affecting the skin or oral mucosa caused by overgrowth of the common yeast (fungus) Candida. Formerly called moniliasis.

Cariostatic

Having the ability to help prevent dental caries.

Cartilage

Tissue material covering bone. The nose, outer ears, and trachea consist primarily of cartilage.

Celiac Disease

Gluten intolerance.

Celiac Spruce

An inherited, autoimmune disease in which the lining of the small intestine is damaged from eating gluten and other proteins found in wheat, barley, rye, and possibly oats. Also known as gluten enteropathy.  May be 10 times more prevalent in Sjögren's patients than in general population.

Central Nervous System

The brain and spinal cord.

Cheilitis

Sores at the corners of the mouth (angles of the lips).

Chronic Active Hepatitis

A disorder that occurs when viral hepatitis proceeds in an active state beyond its usual cause.

Chronic Fatigue Syndrome

Best defined as a low-energy state characterized by physical or mental weariness.

Collagen Vascular Disease

See connective tissue disease.

Complement

A protein consumed with inflammation and levels may be decrease in Sjögren's.

Complementary Medicine

Nonprescription use of products found in nature to treat medical conditions. Also includes noninvasive mind body techniques such as biofeedback, acupuncture, yoga.

Complete Blood Count (CBC)

A blood test measuring the amount of red cells, white blood cells, and platelets in the body.

Congenital Heart Block

A dysfunction of the rate/rhythm conduction system in the fetal or infant heart caused by antibodies to SSA or SSB.

Conjunctiva

The mucous membrane covering the outside of the eyeball and the inner lining of the eyelids.

Connective Tissue Disease

A disorder marked by inflammation of the connective tissue (joints, skin, muscles) in multiple areas. In most instances, connective tissue diseases are associated with autoimmunity.

Constitutional Symptoms

A symptom that affects the general well-being or general status of a patient. Examples include weight loss, shaking, chills, fever, and vomiting.

Contrast Sialography

This test assesses the structure of the major salivary glands.

Cornea

The clear "watch crystal" structure covering the pupil and iris (colored portion of the eye). It is composed of several vital layers, all of which are functionally important. The surface layer, or epithelium, is covered by the tears, which lubricate and protect the surface.

Corticosteroid

A hormone produced by the adrenal cortex gland. Natural adrenal gland hormones have powerful anti-inflammatory activity and are often used in the treatment of severe inflammation affecting vital organs. The many side effects of corticosteroids should markedly curtail their use in mild disorders.

Costochondritis

An irritation of a rib and adjoining cartilage and causing chest pain.

CREST Syndrome

A limited form of scleroderma characterized by C (calcium deposits under the skin), R (Raynaud's phenomenon), E (esophageal dysfunction), S (sclerodactyly or tight skin) and T (a rash called telangiectasia).

Crossover Syndrome

An autoimmune process that has features of more than one rheumatic disease.

Crossover Syndrome

An autoimmune process that has features of more than one rheumatic disease.

Cryoglobulinemia

A condition whereby protein complexes circulating in the blood become deposited during cold weather), and vasculitis (inflammation of blood vessels.

Cryoglobulins

Protein complexes circulating in the blood that are precipitated during cold.

Cryptogenic Cirrhosis

Liver disease of unknown etiology (origin) in patients with no history of alcoholism or previous acute hepatitis.

Cytokine

A group of chemicals that signal cells to perform certain actions.

D
Demineralization

The process of removing hard minerals (calcium) from the tooth surface.  Progressive removal of these minerals results in a progressive dental cavity. This is part of the dental caries process.

Demyelination

Areas of damage to the coatings of the nerve fibers.

Dendritic Cells

Immune cells that form part of the mammalian immune system.

Dental Caries

A process in which the tooth is gradually dissolved (demineralized) by acids from bacteria attached to the surface, which leads to progressive cavitation.  If the caries process is allowed to continue without treatment, it will progress through the tooth into its pulp (containing the nerve of the tooth).  Also known as dental decay or cavity.

Dermatomyositis

An autoimmune process directed against muscles associated with skin rashes.

Diuretics

Medications that increase the body's ability to rid itself of fluids.

Docosahaexanoic (DHA)

An omega-3 fatty acid.

Double Blind Study

One in which neither the physician nor the patients being treated know whether patients are receiving the active ingredient being tested or a placebo (an inactive substance).

Dysautonomia

Dysautonomia is a broad term that includes all of the different forms of autonomic nervous system dysfunction, including damage to the autonomic nerves, or intact autonomic nerves that aren't working properly. Autonomic nerves help regulate your heart rate, blood pressure, digestion, saliva and tear production, and other "automatic" bodily functions.

Dysorexia

Impaired or deranged appetite.

Dyspareunia

Painful sexual intercourse.

Dyspepsia

Can be defined as painful, difficult, or disturbed digestion, which may be accompanied by symptoms such as nausea and vomiting, heartburn, bloating, and stomach discomfort. (upset stomach).

Dysphagia

Difficulty in swallowing. In Sjögren’s this may be attributable to several causes, among them a decrease in saliva, infiltration of the glands at the esophageal mucosa, or esophageal webbing.

Dyspnea

Air hunger resulting in labored or difficult breathing, sometimes accompanied by pain.

Dysuria

Pain on urination.

E
Ecchymosis

A purplish patch caused by oozing of blood into the skin; ecchymoses differ from petechiae in size.

Edema

Swelling caused by retention of fluid.

Eicosapaentanoic (EPA)

An omega-3 fatty acid found in fish oils.

Electromyography (EMG)

A technique for evaluating and recording the electrical activity produced by skeletal muscles.

ELISA (Enzyme Linked Immunosorbent Assay)

A very sensitive blood test for detecting the presence of autoantibodies.

Endoscopy

A procedure by which your doctor uses a small, flexible tube called an endoscope, to view your esophagus, stomach and duodenum.

Epigenetics

An emerging field that studies how these heritable modifications that do not involve changes in the nucleotide sequence lead to altered gene expression.

Epistaxis

Nosebleed or hemorrhaging from the nose, which may be caused by dryness of the nasal mucous membrane in Sjögren’s.

Epithelial

The outside layer of cells that covers all the free, open surfaces of the body including the skin, and mucous membranes that communicate with the outside of the body.

Erythema

A medical term for a red color, usually associated with increased blood flow to an inflamed area, often the skin.

Erythrocyte

Red blood cell.

Erythrocyte Sedimentation Rate (ESR)

Measures the degree to which whole blood, collected in tubes containing a chemical that prevents clotting (anticoagulant), separates into plasma (the upper layer) and packed red cells (the lower layer) over the course of one hour.  Elevated with inflammation.

Esophageal Dysmotility

Muscular incoordination of the esophagus.  May affect up to 1/3 of SS patients with dysphagia.

Esophagitis

Prolonged reflux of acid results in chronic irritation of the esophagus.

Esophagus

A canal (narrow tube) with muscular walls allowing passage of food from the pharynx, or end of the mouth, to the stomach.

Estrogens

Any of several steroid hormones produced chiefly by the ovaries and responsible for promoting estrus and the development and maintenance of female secondary sex characteristics.

Etiology

The cause(s) of a disease.

Eustachian Tube

The tube running from the back of the nose to the middle ear.

Exocrine Glands

Glands that secrete outside the body (e.g. lacrimal, salivary or sweat glands).

Exocrinopathy

Disease related to the exocrine glands.

Extraglandular

Outside of the glands.

F
Fibromyalgia

A form of non-neuropathic chronic neuromuscular pain associated with fatigue, disordered sleeping, and tender points in the soft tissues.

Fibrosis

Abnormal formation of fibrous tissue.

Filamental Keratopathy

Mucus strands stick to the cornea at sites of focal desiccation and surface cells extend onto the strand making it very adherent to the cornea causing discomfort or even pain when blinking pulls on the strand.

Fissure

A crack in the tissue surface (skin, tongue, etc.).

Fluorescein Stain

A dye that stains areas of the eye surface in which cells have been lost.

Focal Lymphocytic Sialoadenitis

A characteristic pattern of inflammation.

G
Gastritis

Stomach inflammation.

Gastro-Esophageal Reflux (GERD)

Muscle tone in the wall of the esophagus is reduced, gastric juice moves up the esophagus, producing a burning sensation behind the breastbone (heartburn) and chest pain.

Gene

Consisting of DNA, it is the basic unit of inherited information in our cells that control the physical traits that are passed from parents to their offspring.

Gene Therapy

A method of treating disease by introducing normal DNA directly into cells to correct a genetic defect that is causing the disease.

Gene Transfer

The insertion of unrelated genetic information in the form of DNA into cells.

Genetic Factors

Traits inherited from parents, grandparents, and so on.

Genetics

Broadly refers to the study of genes.

Genome

All of the genetic information, the entire genetic complement, all of the hereditary material possessed by an organism.

Genome-Wide Association Study (GWAS):

Allows the scientist to rapidly scan the complete set of DNA, or genome, of many individual people to find genetic variations associated with a complex disease, such as Sjögren’s.

Gingiva

The gums.

GIngivitis

Inflammation of the gums.

Globulin

A protein whose levels increase in inflammation.

Glomerulonephritis

Inflammation of the kidney; seen in 10% with Sjögren's.

Goblet Cell

Any of the specialized epithelial cells found in the mucous membrane of the stomach, intestines, and respiratory passages that secrete mucus.

Granulocytes

A type of white blood cell.

Granuloma

A nodular, inflammatory lesion.

Grave's Disease

A form of autoimmune thyroid disease.

H
Halitosis

Bad breath.

Hashimoto’s Thyroiditis

The most common form of thyroiditis and the most frequent cause of hypothyroidism. 

Helicobacter Pylori

A common chronic bacterial infection of the stomach. Associated with increased risk of gastrointestinal (MALT)lymphoma.

Hepatitis

Inflammation of the liver; seen in Sjögren’s patients who have biliary cirrhosis.

Hepatitis C Virus

Not associated with Sjögren’s but can present with sicca symptoms mimicking Sjögren's.

Homeopathy

A method of treating disease with small amounts of remedies that, in large amounts in healthy people, produce symptoms similar to those being treated.

Hormone Replacement Therapy (HRT):

Therapy with estrogen and progesterone that is commonly used in menopause for severe hot flashes, disrupted sleep, and in some cases mild depressive symptoms.

Hormones

Chemical messengers--including thyroid, insulin, steroids, estrogen, progesterone and testosterone---made by the body.

Hydroxychloroquine

Anti-inflammatory drug (trade name Plaquenil) used in the treatment of autoimmune conditions such as rheumatoid arthritis, Sjögren’s and lupus erythematosus.

Hyperalgesia

An extreme reaction to a stimulus that is not normally painful.

Hypergammaglobulinemia

A medical condition with elevated levels of gamma globulin.

Hypergammaglobulinemic Purpura

A type of skin rash, which is a purple brown color.

Hypokalemia

Low potassium.

Hypothyroidism

A condition in which the thyroid gland does not make enough thyroid hormone.

I
Idiopathic

Of unknown cause.

Immunogenetics

The study of genetic factors that control the immune response.

Immunoglobulin E (IgE):

Antibody associated with allergies.

Immunoglobulins (Gamma Globulins)

The protein fraction of serum responsible for antibody activity. Measurement of serum immunoglobulin levels can serve as a guide to disease activity in some patients with Sjögren’s.

Immunomodulators

Medications that affect the body's immune system.

Immunosuppressive Agents

A class of drugs that interferes with the function of cells composing the immune system. Drugs used in the chemotherapy of malignant disease and in the prevention of transplant rejection are generally immunosuppressive and occasionally are used to treat severe autoimmune disease. Also see lymphocyte.

Incisal

Cutting edge (of a tooth).

Indigestion (Dyspepsia)

A painful or burning feeling in the upper abdomen and is usually accompanied by nausea, bloating or gas, a feeling of fullness, and, sometimes, vomiting.

Innate Immunity

Primitive responses to bacteria and viruses via a pattern recognition mechanism.

Interferon

A protein made to protect the body from infection that is overactive in Sjögren's.

Interstitial

Supporting structure of the substance of an organ or tissues.

Interstitial Cystitis

Inflammation of the bladder.

Interstitial Lung Disease

When the lung itself becomes inflamed.

Interstitial Nephritis

Inflammation of the connective tissue of the kidney, usually resulting in mild kidney disease characterized by frequent urination. Interstitial nephritis may be associated with Sjögren’s.

Interstitial Pneumonitis

An inflammation of the supporting tissue around the alveoli (air sacs) of the lungs caused by the autoimmune process.

Intraoral

Inside the mouth.

Intrathoracic

Within in the cavity of the chest.

Irritable Bowel Syndrome

Spastic colitis or irritable bowel.

IV Immunoglobulin or IVIg

A blood product made from the plasma component of blood pooled from thousands of donors. It contains immunoglobulins, which interact with the immune system in order to suppress it.

J
Jaundice

Yellowing of the skin.

K
Keratoconjunctivitis Sicca

Condition, also called dry eye, that most frequently occurs in women in their forties and fifties. If it is associated with a dry mouth and/or rheumatoid arthritis, the condition is referred to as Sjögren’s.

L
Lacrimal

Relating to the tears.

Lacrimal Glands

Two types of glands that produce tears. Smaller accessory glands in the eyelid tissue produce the tears needed from minute to minute. The main lacrimal glands, located just inside the bony tissue surrounding the eye, produce large amounts of tears.

Laryngopharyngeal Reflux (LPR):

Reflux of gastric contents and acids to the level of the throat, can lead to symptoms of hoarseness, chronic cough, throat clearing, mild pharyngeal dysphagia, or globus sensations (sensation of a lump or foreign body in the throat).

Laryngotracheobronchitis

An acute respiratory infection involving the larynx, trachea, and bronchi. Also called croup.

Larynx

Voice box.

Latent

Not manifest but potentially discernible.

Leukopenia

Low numbers of white cells.

Leukorrhea

A whitish, viscid discharge from the vagina and uterine cavity.

Lip Biopsy

Incision of approximately 2 cm on the inside surface of the lower lip and excision of some of the minor salivary glands for microscopic examination and analysis.

Lissamine Green

A vital stain with dyeing quality similar to that of Rose Bengal, but which causes less discomfort. It stains dead or degenerated epithelial cells green and is used to facilitate the diagnosis of keratoconjunctivitis sicca, xerophthalmia, etc.

Lymph

A fluid collected from the tissues throughout the body, flowing through the lymph nodes and eventually added to the circulating blood.

Lymphadenopathy

Abnormally enlarged lymph nodes. Commonly called "swollen glands."

Lymphocyte

A type of white blood cell concerned with antibody production and regulation. Collections of lymphocytes are seen in the salivary glands of Sjögren’s patients.

Lymphoma

A proliferation (increase) of abnormal (malignant) lymphocytes that has many different types. Two of those types are known to develop in a small proportion of Sjögren’s patients: MALT (mucosa-associated lymphoid tissue) lymphoma (also called extra nodal marginal zone lymphoma), which is very slow growing, may cause progressive salivary gland enlargement, and is rarely fatal; the other type, large B-cell lymphoma occurs even less frequently, but can be aggressive.

Lymphoproliferation

The excessive production of lymphocytes.

M
Macrophage

A cell that kills foreign material and presents information to lymphocytes.

MALT (Mucosa-Associated Lymphoid Tissue)

Associated with the mucosa, the moist lining of some organs and body cavities. MALT refers to the most common type of lymphoma in Sjögren’s.

Manometry

The diagnosis of dysmotility is made by measuring the pressure inside the wall of the esophagus during swallowing.

Matrix

The section of the tooth enamel that holds calcium and phosphate minerals.

Meibomian Glands

Fat-producing glands in the eyelids that produce an essential component of tears.

MHC

Major histocompatibility complex. In humans, it is the same as HLA.

Mixed Connective Tissue Disease

A connective tissue disease that manifests as an overlap of other connective-tissue disorders.

Mucin

Thinnest layer of the tear film; layer closest to the cornea.

Mucolytic Agents

Medications that tend to dissolve mucus. Most patients with dry eye complain of excess mucous discharge. Some patients may benefit from these medications if other tear-film enhancing drops are not very effective.

Myalgia

Muscle pains.

N
Necrosis

Tissue death.

Neonatal Lupus Syndrome

A rare autoimmune disorder that is present at birth in patients with anti SSA or SSB and usually manifests itself with a rash or hear block.

Nephritis

An inflammation of the kidneys.

Nerve Conduction Study

A test commonly used to evaluate the function, especially the ability of electrical conduction, of the motor and sensory nerves of the human body.

Neutrophil

A granulated white blood cells involved in bacterial killing and acute inflammation.

Nonspecific

Caused by other diseases or multiple factors.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDS):

Anti-inflammatory agents blocking the action of prostaglandins used to treat pain that occur in rheumatoid arthritis and other connective-tissue disorders. Examples include ibuprofen (Motrin, Advil) and naproxen (Aleve).

Norepinephrine

A hormone and neurotransmitter secreted by the adrenal medulla and the nerve endings of the sympathetic nervous system to cause vasoconstriction and increases in heart rate, blood pressure, and the sugar level of the blood.

O
Olfactory

Relating to the sense of smell.

Ophthalmologist

A physician who specializes in diseases and surgery of the eye.

Optic Neuritis

The inflammation of the optic nerve that may cause a complete or partial loss of vision.

Oral Mucosa

The lining (mucous membrane) of the mouth.

Oral Soft Tissue

Tongue, mucous lining of the cheeks, and lips.

Orthostasis

Maintenance of an upright standing posture.

Otalgia

Ear pain.

Otitis

Inflammation of the ear, which may be marked by pain, fever, abnormalities of hearing, deafness, tinnitus (a ringing sensation), and vertigo. In Sjögren’s, blockage at eustachian tubes due to infection can lead to conduction deafness and chronic otitis.

Otolaryngologist

Physician specializing in ear, nose, and throat disorders.

P
Palate Biopsy

A punch biopsy near the junction of the hard and soft palates to sample the minor salivary glands in that region.

Palpable

Perceptible to touch.

Palpable Purpura

Rashes, particularly eruptions of small red raised on the extremities that can cause skin changes in SS patients.

Pancreatitis

Acute inflammation of the pancreas.

Parasympathetic Nervous System

The part of the autonomic nervous system whose functions include constriction of the pupils of the eyes, slowing of the heartbeat, and stimulation of certain digestive glands. These nerves originate in the midbrain, the hindbrain, and the sacral region of the spinal cord; impulses are mediated by acetylcholine.

Parotid Gland Flow

An empirical quantitative measure of the amount of saliva produced over a certain period of time. Normal parotid gland flow rate is 1.5 ml/min. In Sjögren’s, the flow rate is approximately 0.5 ml/min, with diminution of the flow rate correlating inversely with the severity of disease.

Parotid Glands

One of the three pairs of major salivary glands. They are located in front of the ear.

Parotid Scintigraphy

This is a nuclear medicine test that evaluates the function of the parotid and submandibular gland.

Pathogenesis

The development of a disease.

Peptides

Any of various natural or synthetic compounds containing two or more amino acids linked by the carboxyl group of one amino acid to the amino group of another.

Perforation

A hole.

Pericarditis

Inflammation of the lining around the heart (the pericardium).

Pericardium

The lining of the heart.

Perimenopause

A variable time of irregular menses beginning a few years before the menopause.

Periodontitis

Inflammation of the gums and soft tissue and bone surrounding and supporting the teeth.

Peripheral Nerves

Nerves outside the central nervous system.

Peripheral Neuropathy

A problem with the nerves that carry information to and from the brain and spinal cord. This can produce pain, loss of sensation, and an inability to control muscles.

Pernicious Anemia

A blood disorder caused by inadequate vitamin B12 in the blood.

Petechia

A small, pinpoint, nonraised, perfectly round, purplish red spot caused by intradermal or submucosal hemorrhaging.

Phagocytic Cells

Cells, such as a white blood cells, that engulfs and absorbs waste material, harmful microorganisms, or other foreign bodies in the bloodstream and tissues.

Pharynx

Throat.

Photosensitivity

Sensitivity to ultraviolet light.

Placebo

An inactive substance used as a “dummy” medication.

Plaque

A thin, sticky film that builds up on the teeth, trapping harmful bacteria.

Plasma

The fluid portion of the circulating blood.

Plasmapheresis

Filtration of blood plasma through a machine to remove proteins that may aggravate Sjögren's.

Pleura

A sac lining the lung.

Pleurisy

Inflammation of the pleura (membrane surrounding the lungs and lining the walls of the rib cavity).

Polychondritis

Inflammation and destruction of the cartilage of various tissues of the body.

Polyclonal

Derived from different cells.

Polymyositis

A connective tissue disorder characterized by muscle pain and severe weakness secondary to inflammation in the major voluntary muscles.

Polysomnography

Sleep study.

Primary Biliary Cirrhosis (PBC)

Impairment of bile excretion secondary to liver inflammation and scarring.

Probiotics

The administration of good bacteria which kills bad gut bacteria.

Progestins

Any one of a group of steroid hormones that have the effect of progesterone.

Prostaglandins

Produced by the body and are responsible for inflammation features, such as swelling, pain, stiffness, redness and warmth.

Protein

A collection of amino acids. Antibodies are proteins.

Proteinuria

Excess protein levels in the urine (also called albuminuria).

Proteomics

The study of proteins.

Pruritis

Itching.

Psoralen

A drug administered orally or topically for the treatment of vitiligo (white patches caused by loss of pigment).

Puncta

Small holes in the eyelids that normally drain tears. Patients with severe dry eye benefit from punctal closure, which allows maximal tear preservation.

Punctal Plugs

Inserted to increase the volume of tears retained on the surface of the eye also may be needed to allow continued lens wear.

Purpura

A condition characterized by hemorrhage into the skin, appearing as crops of petechiae (very small red spots).

R
Radioactive Isotope

Radioactive material used in diagnostic tests.

Radionuclide Studies

A technique in which radioactive isotopes, such as radiolabeled human serum albumin, are injected into an organ. A gamma scintillation camera, coupled with a digital computer system and a cathode ray display, reads the radioactive emissions. Areas of perfusion will show marked radiographic emissions; areas of obstruction will show no activity.

Raynaud’s Phenomenon

Painful blanching of the fingertips on exposure to cold. This may be seen alone or in association with a connective tissue disease such as Sjögren’s.

Reflux

A regurgitation due to the return of gas, fluid, or small amount of food from the stomach.

Regulatory Immunity

Needed to evolve to facilitate termination of a no-longer-needed adaptive response and, as well, to limit responses to ‘self’ (auto) antigen.

Remineralization

The process of restoring minerals (calcium and phosphate) to the tooth surface.

Renal

Relating to the kidneys.

Renal Tubular Acidosis

Damage of the tubules of the kidney which lowers pH and is associated with renal damage.

Restless Legs Syndrome

Characterized by unpleasant sensations in the limbs, usually the legs, that occur at rest or before sleep and are relieved by activity such as walking.

Rheumatoid Arthritis (RA)

An autoimmune disease and form of arthritis characterized by inflammation of the joints, stiffness, swelling, synovial hypertrophy, and pain. Sjögren’s frequently occurs in conjunction with RA.

Rheumatoid Factor

An autoantibody whose presence in the blood usually indicates autoimmune activity.

Rheumatologist

A physician skilled in the diagnosis and treatment of rheumatic conditions.

Rosacea

A chronic dermatitis of the face, especially of the nose and cheeks, characterized by a red or rosy coloration with deep-seated papules and pustules and caused by dilation of capillaries. Can be mistaken for lupus or anti SSA associated rashes.

Rose Bengal

A dye that stains abnormal cells on the surface of the eye.  When used for diagnosis in patients with significant dry eyes (keratoconjunctivitis sicca), it is very irritating and its use has been generally replaced by the use of lissamine green, an equivalent dye that is not irritating.

S
Salicylates

Aspirin-like drugs.

Salivary Flow Rate

The amount of saliva naturally produced by the salivary glands.

Salivary Glands

Exocrine glands (parotid, submandibular, and sublingual) with ducts, that produce saliva.

Salivary Scintigraphy

Measurement of salivary gland function through injection of radioactive material.

Sarcoidosis

A systemic disease with granulomatous (nodular, inflammatory) lesions involving the lungs and, on occasion, the salivary glands, with resulting fibrosis.

Schirmer's Test

The standard objective test to diagnose dry eye. Small pieces of filter paper are placed between the lower eyelid and eyeball and soak up the tears for five minutes. The value obtained is a rough estimation of tear production in relative terms. Lower values are consistent with dry eye. It is important to emphasize that no single test can be considered diagnostic unless the condition is severe.

Scleroderma

A connective tissue and autoimmune disease characterized by thickening and hardening of the skin. Sometimes internal organs (intestines, kidneys) are affected, causing bowel irregularity and high blood pressure. Sjögren’s is not uncommon in patients with scleroderma.

Sclerosing Cholangitis

A chronic disorder of the liver in which the ducts carrying bile from the liver to the intestine, and often the ducts carrying bile within the liver, become inflamed, thickened, scarred (sclerotic), and obstructed.

Sclerosing Sialedenitis

Swelling and inflammation of the salivary glands with scarring.

Secretogogue

A medication that can stimulate salivary flow.

Serotonin

A chemical produced by the brain that functions as a neurotransmitter. It plays a part in the regulation of mood, sleep, learning and constriction of blood vessels (vasoconstriction).

Serum

The fluid portion of the blood (obtained after removal of the fibrin clot and blood cells), distinguished from the plasma in the circulation blood.

Serum Protein Electrophoresis

A laboratory test that examines specific proteins in the blood called globulins. A measurement and breakdown of albumin and globluons.

Serum Sickness

A delayed allergic reaction to the injection of an antiserum caused by an antibody reaction to an antigen in the donor serum.

Sialochemistry

Measurement of the constituents in saliva.

Sialography

X-ray examination of the salivary duct system by use of liquid contrast medium. Radiologically sensitive dye is placed into the duct system, outlining the system clearly.

Sicca

An autoimmune disease, also known as Sjögren's, that classically combines dry eyes, dry mouth, and another disease of connective tissue such as rheumatoid arthritis (most common), lupus, scleroderma or polymyositis.

Signs

Changes that can be seen or measured.

Sinusitis

Sinus inflammation.

Sjögren’s Antibodies

Abnormal antibodies found in the sera of Sjögren’s patients. These antibodies react with the extracts of certain cells, and a test based on this principle can be helpful in the diagnosis of Sjögren’s. See also SSA and SSB.

Sjögren’s Syndrome (SS)

A systemic multi-organ autoimmune disease that generally has a chronic or progressive course and is characterized by, but not limited to, secretory dysfunction. It may occur alone or precede or follow the occurrence of other autoimmune diseases in the same patient.

SLE (Systemic Lupus Erythematosus)

An inflammatory connective tissue disease.

SSA

Sjögren’s syndrome–associated antigen A (anti Ro).

SSB

Sjögren’s syndrome–associated antigen B (anti La).

Steatorrhea

Passage of large amounts of fat in the feces, as occurs in pancreatic disease and the malabsorption syndromes.

Steroids

Cortisone-derived medications.

Subacute Cutaneous Lupus (SCLE)

A unique set of photosensitive rashes, originally described in patients with lupus, may occur in Sjögren’s and are common in patients with anti-SSA (Ro) and anti-SSB (La) antibodies.

Sublingual Glands

One of the three pairs of major salivary glands. They are located in the floor of the mouth under the tongue.

Submandibular Glands

One of the three pairs of major salivary glands. They are located below the lower jaw.

Symptoms

Changes patients feel.

Synovitis

Inflammation of the tissues lining a joint.

Synovium

Tissue that lines a joint.

Systemic

Any process that involves multiple organ systems throughout the body.

Systemic Lupus Erythematosus (SLE)

An autoimmune disease that is closely related to Sjögren’s syndrome, occurs frequently in conjunction with Sjögren’s, and can damage any body organ or system.

T
T cell

A lymphocyte (white blood cell) responsible for immunologic memory.

Tear Breakup Test

Measurement of tear breakup time is a standard part of the evaluation of dry eye since instability of the tear film is a characteristic of both forms of dry eye.

Tear Film

Protects and lubricates the cornea and the rest of the ocular surface. Natural tears are mostly water containing a complex mixture of proteins and other components.

Tear Osmolarity Test

Tear osmolarity testing measures the concentration of the tear film which can be elevated in either aqueous deficient or evaporative dry eye.

Thrombocytopenia

Low platelet counts.

Thrush

A form of candidiasis. Infection of the oral tissues with Candida albicans.

Thymus

A gland in the neck responsible for immunologic memory.

Thyroiditis

A disease in which autoantibodies cause immune system cells (lymphocytes) to destroy the thyroid gland.

Tinnitus

Ringing in the ears.

Titer

Test showing the strength or concentration of a particular volume of a solution. Usually refers to amounts of antibody present.

TMJ (Temporomandibular Joint)

The joint of the lower jaw where the ball-and socket arrangement is formed by the condyle of the lower jaw (the ball) and the fossa of the temporal bone (the socket). The joint space is filled with synovial or lubricating fluid. This joint and the surrounding synovial tissues may become inflamed if rheumatoid arthritis accompanies Sjögren’s and involves the joint.

Tolerance

The failure to make antibodies to an antigen.

Toll Receptor

A pattern-recognition feature of the innate immune system.

Trachea

Windpipe.

Tracheobronchial Tree

The windpipe and the bronchi into which it subdivides.

Trigeminal Nerve

The chief nerve of sensation for the face and the motor nerve controlling the muscles of mastication (chewing).

Tumor Necrosis Factor (TNF)

A cytokine produced primarily by monocytes and macrophages that promotes inflammation.

U
UCTD (Undifferentiated Connective Tissue Disease)

Features of autoimmunity such as inflammatory arthritis or Raynaud’s in a patient who does not meet the ACR criteria for lupus, rheumatoid arthritis or other disorders.

Ultraviolet Light (UV Light)

A spectrum of light including UVA (320–400 nanometers), UVB (290–320 nanometers), and UVC (200–290 wavelengths).

Urinalysis

Examination of urine under a microscope.

Urticaria

Hives.

V
Vasculitis

Inflammation of a blood vessel.

Venous Thromboses

Clots in veins of the of the lower extremities and less frequently the lungs.

Venule

A very small vein.

Viscera

The organs of the digestive, respiratory, urogenital, and endocrine systems, as well as the spleen, heart, and great vessels (blood and lymph ducts).

Vitamin B12 Deficiency

A reduction in vitamin B12 from inadequate dietary intake or impaired absorption.

Vitamin D

A fat-soluble vitamin that enhances the absorption of calcium and phosphorus from the intestine and promotes their deposition onto the bone.

Vitiligo

White patches on the skin due to loss of pigment.

W
WBC

White blood cell.

X
Xerophthalmia

Dry eyes.

Xerostomia

Dryness of the mouth caused by the arresting of normal salivary secretions. It occurs in diabetes, drug therapy, radiation therapy, and Sjögren’s.

Xserosis

Abnormal dryness of the skin (xerderma), of the conjunctiva of the eye (xerophtalmia), or of the mucous membranes such as dry mouth (xerostomia).

Xylitol

 sweetening agent with cariostatic properties.