Sjögren's syndrome

Medicine 3

Head of Department:
Prof. Dr. med. univ. Georg Schett

Understanding causes

Sjögren's syndrome is a chronic autoimmune disease in which the immune system's defence cells attack the salivary and lacrimal glands, leading to functional disorders.

Facts and figures around the disease

The majority of women suffer from the disease (approx. 90%). They often also suffer from  rheumatoid arthritis, systemic sclerosis, vasculitis, destructive non-purulent cholanngitis or chronic active hepatitis.

Typical symptoms and course of the disease at a glance

Umbrella test: A filter paper strip is attached to the outer eyelid angle in the conjunctival sac. After 5 minutes the tear fluid in healthy persons has covered more than 10 mm in the paper strip.

The general signs of the disease include increased body temperature, muscle pain and aching salivary and parotid glands as well as lymph nodes. Further symptoms may occur individually or in combination in the following organs:

Further symptoms may occur individually or in combination in the following organs:

Eyes

  • Aridity
  • Foreign body sensation
  • Corneal defects
  • Lack of lacrimation

Mouth

  • Dry mouth
  • Gluing of the tongue
  • Impossibility to eat dry biscuits
  • Tendency to caries
  • Burning of the tongue
  • Swallowing difficulties
  • Sensation of thirst

Further signs

  • 60% one-sided or two-sided enlargement of the parotid gland
  • It can also lead to recurrent bronchitis, inflammation of the trachea or nasal wall mucosa.
  • Dysfunctions of the pancreas
  • Dryness of the vaginal mucosa

How does the physician make the diagnosis?

  • Clinical examination to classify disease activity according to European classification criteria
  • Measurement of antibodies and rheumatoid factor
  • Measurement of ignition values
  • Blood count
  • Investigation and measurement of tear wetting (screen test)
  • Examination and measurement of stimulated salivary secretion
  • Salivary gland and tear gland biopsy
  • Differentiation to other salivary gland diseases and tumors as well as to diseases of the lymph glands and viral infections

How is Sjögren’s syndrome treated?

The therapy is set up individually according to the respective symptoms.
In principle, measures are taken to promote the flow of saliva (e.g. using chewing gum and sweets). In addition, artificial tear fluid is administered against the dryness of the eyes.

If the disease is more active, saliva production is stimulated with drugs such as pilocarpine derivatives, bromhexine or the local application of ciclosporin.

If internal organs are also affected, immunosuppressive therapy inhibits the inflammatory reaction, e.g. with glucocorticoids.

Practical tips for everyday life

Drink enough and protect your eyes from smoke and wind.

 
information brochure