Keratoconjunctivitis sicca (Sjögren syndrome)
Keratoconjunctivitis sicca, or 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.
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
· Systemic lupus erythematosus
Dry eyes and dry mouth are the most common symptoms of this syndrome.
· Itching eyes
· Feeling that something is in the eye
Mouth and throat symptoms:
· Difficulty swallowing or eating
· Loss of sense of taste
· Problems speaking
· Thick or stringy saliva
· Mouth sores or pain
Other symptoms may include:
· Change in the color of hands or feet
· Joint pain or joint swelling
· Swollen glands
A physical exam reveals dry eyes and mouth. There may be mouth sores because of the mouth dryness.
You may have the following tests:
· Schirmer's test of tear production
· Antinuclear antibodies (ANA) test
· Salivary gland biopsy
· Rheumatoid factor (possible)
· Tear test
· Slit lamp examination of the eyes
The goal is to relieve symptoms.
· Dry eyes may be treated with artificial tears, eye-lubricating ointments, or cyclosoporine liquid.
· Tiny plugs can be placed in the tear drainage ducts to help the tears stay on the surface of the eye.
Disease modifying drugs (DMARDs) similar to those used for rheumatoid arthritis may improve the symptoms of Sjögren syndrome. These include tumor necrosis factor (TNF) inhibiting drugs such as Enbrel, Humira or Remicaide.
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
· Drugs that help your salivary glands make more saliva
To prevent dental decay that can be caused by mouth dryness:
· Brush and floss your teeth often
· Visit the dentist for regular checkups and cleanings
The disease is usually not life-threatening. The outcome depends on what other diseases you have.
There is a higher risk of lymphoma when Sjörgen syndrome has been very active for a long time.
· Damage to the eye
· Dental cavities
· Kidney failure (rare)
· Pulmonary infections
· Vasculitis (rare)
Call your health care provider if you develop symptoms of Sjögren syndrome.