Sjögren's syndrome is an autoimmune disease characterized primarily by the immune system's abnormal attack on the lacrimal and salivary glands, leading to dryness of the mucous membranes and related tissues. Symptoms vary among individuals, but dry mouth and dry eyes are the most common early signs. Patients may experience multi-system involvement gradually over weeks to years, which can significantly impact daily quality of life in severe cases.
This group of symptoms can be divided into primary symptoms and secondary symptoms. Primary symptoms directly result from immune-mediated glandular attack, while secondary symptoms may be caused by long-term dryness leading to infections or tissue damage. Early diagnosis is crucial for delaying disease progression, so understanding symptom patterns can help patients seek professional medical assistance promptly.
Early symptoms typically manifest as dryness of the mouth and eyes, which may be mistaken for general fatigue or environmental factors. Patients often describe difficulty swallowing, especially when eating dry or hard foods, requiring frequent water intake. Increased ocular secretions or foreign body sensation may be mistaken for allergic reactions, but reduced tear production gradually increases the risk of corneal damage.
Other early signs include:
Dry mouth (xerostomia) may cause cracks on the tongue surface, taste abnormalities, and frequent thirst. Increased viscosity of saliva can lead to sticky secretions, raising the risk of oral infections. Dry eyes (keratoconjunctivitis sicca) may cause corneal staining or ulcers, and patients may require long-term use of artificial tears.
About 40% of patients experience systemic symptoms, including muscle weakness, joint pain, and unexplained fatigue. These symptoms may be associated with immune system hyperactivity and can fluctuate intermittently. Some patients may also experience skin dryness or vaginal dryness, affecting daily activities and quality of life.
As the disease advances, the immune system may attack other exocrine glands, such as the respiratory or gastrointestinal mucosa, leading to cough or difficulty swallowing. Some patients develop secondary symptoms like salivary gland swelling or lymphadenopathy, which can serve as important diagnostic clues.
Untreated long-term cases may develop severe complications such as tooth loss, retinal lesions, or peripheral neuropathy. The severity of symptoms can be influenced by environmental factors, with dry climates or medications (e.g., antihistamines) potentially exacerbating manifestations.
If dry mouth or dry eyes persist for more than 3 months and interfere with daily life, immediate medical evaluation is recommended. The presence of unexplained joint swelling, skin ulcers, or recurrent oral infections may indicate progression to a second stage. Severe symptoms such as worsening vision or difficulty swallowing require urgent medical assessment to prevent tissue damage.
Patients are advised to keep a symptom diary to track frequency and severity. The presence of systemic symptoms (e.g., low-grade fever, unexplained weight loss) or organ-specific symptoms (e.g., abnormal liver function) warrants prompt immunological testing for diagnosis confirmation.
Increasing environmental humidity, sucking on sugar-free lozenges to stimulate saliva, using artificial tears to moisturize the eyes, and avoiding tobacco and alcohol irritants can help. Regular oral hygiene prevents infections, and using fragrance-free lip balms can alleviate chapped lips. It is recommended to drink small amounts frequently, choose sugar-free gum to stimulate saliva, and maintain adequate hydration.
What are possible side effects of medications used to treat Sjögren's syndrome?Antimalarial drugs like hydroxychloroquine may cause gastrointestinal discomfort or retinal issues, requiring regular eye examinations. Immunosuppressants can suppress immune function and increase infection risk, so blood counts should be monitored closely during treatment. Topical agents such as artificial tears or saliva substitutes are preferred for localized symptoms to reduce systemic drug side effects.
What precautions should be taken during dental examinations for Sjögren's patients?Due to decreased saliva, there is an increased risk of caries and periodontal disease. It is recommended to have dental check-ups every six months, use fluoride mouth rinses for added protection, and inform the dentist of the dry syndrome history. Avoid medications that may worsen dry mouth. Severe cases may consult physicians about using saliva-stimulating drugs or topical therapies.
How can Sjögren's syndrome be distinguished from lupus erythematosus?Although both are autoimmune diseases, Sjögren's primarily presents with dry mouth and dry eyes, whereas lupus often involves joint pain, skin rashes, and systemic inflammation markers. Sjögren's patients may develop pulmonary fibrosis or peripheral neuropathy, but fever and positive antinuclear antibody (ANA) are less common compared to lupus.
Which foods in daily diet may worsen symptoms?Spicy, salty, or dry/hard foods can aggravate dryness discomfort. It is advisable to choose moist foods like soups or pureed fruits, avoid sugary snacks to reduce caries risk. Adequate intake of vitamin C can help maintain mucosal health, but excessive caffeine should be avoided as it has diuretic effects that may worsen dehydration.
%201.svg)
Copyright © 2025 MedFrontiers. All Rights Reserved.
