The autoimmune disorder Sjögren's syndrome can cause dry eyes and dry mouth.
Earl: Sjögren's syndrome is a condition that affects between 1 and 4 million Americans. It usually occurs in women after menopause, but it can occasionally occur in younger women, in men and in children.
Illei: Sjögren's syndrome is a systemic autoimmune disease.
Earl: Dr. Gabor Illei is the head of the Sjögren's Syndrome Clinic at the National Institute of Dental and Craniofacial Research at NIH. He explains that exocrine glands like the salivary gland that produces saliva and the lacrimal gland that makes tears are involved in this autoimmune disease.
Illei: In an autoimmune disease, one's own immune system that is there to protect us from viruses, bacteria, cancers and so on turns against our own body and they attack different organs. This is what is happening in Sjögren's.
Earl: Sjögren's can cause dry eyes or dry mouth, but also is associated with rheumatoid arthritis, a painful type of arthritis that causes swelling and stiffness.
Illei: There are various forms of Sjögren's syndrome and for most patients the most bothersome syndromes are related to the dryness as well as fatigue. But there is a minority of patients who get more severe systemic involvement like involvement of the lungs, the nervous system, and those people really need more aggressive treatment whereas the majority of the Sjögren's patients receive mainly symptomatic treatment.
Earl: Because tears and saliva are protective, the dryness in Sjögren's can lead to infections and other problems.
Illei: We recommend to have plenty of water and Sjögren's syndrome patients usually have water at their hand all the time, to use certain physical measures to increase saliva production like the use of sugar-free gums or candies.
Earl: Cavities, he notes, are another risk of dry mouth.
Illei: In the eyes, we use artificial tears that can be bought over-the-counter; when it's more severe, then certain glasses that can protect the eye from drying out. But there are also some medications that we can use in more severe cases.
Earl: But how do you know if you have Sjögren's syndrome? Dr. Illei says that diagnosing Sjögren's syndrome is a multi-step process, and can take a long time.
Illei: One problem with Sjögren's syndrome is that the average time to diagnose Sjögren's is about seven years from the first symptoms because the symptoms can be very subtle.
Earl: Physicians have to show objective evidence of eye and mouth dryness, and that the immune system is attacking the body. Inflammation of the salivary glands and autoantibodies—antibodies that recognize the body's own tissues—are markers of autoimmunity.
Illei: We can measure tear production fairly easily; we can measure saliva production fairly easily. Autoantibodies can be measured in blood tests and we can do biopsies of the minor salivary glands which are small glands in the inner side of the lip and take them out and then look under the microscope if there is inflammation.
Earl: Because Sjögren's syndrome can involve so many different parts of the body, including the eyes, mouth, lungs, and joints, patients with the condition often need to see many specialists.
Illei: In general, I think that especially if someone has systemic involvement, the rheumatologist should be involved who can manage and coordinate the care. I think it is very useful to have an ophthalmologist, an eye doctor involved who can really focus on the optimal management of the eye as well as an oral disease specialist or a dentist who has experience with dry mouth to prevent or correct the effect of dry mouth on the teeth and other structures in the mouth.
Earl: As head of the Sjögren's Clinic at NIH, Dr. Illei explains the clinics role of improving our understanding of how Sjögren's works, and developing new, more effective therapies.
Illei: So we are very patient oriented. We do clinical studies. Some of them are just observational so we follow the disease over time and do certain investigations periodically. Some are interventional; for example, trying out a new treatment or addressing a specific problem of Sjögren's syndrome in more detail. We also include close collaboration with more basic scientists with the goal to find out more about the details of the underlying causes of Sjögren's syndrome.
Earl: Dr. Illei adds there are clinical trials on Sjögren's syndrome currently recruiting. To find out more about a clinical trial near you, visit www.clinicaltrials.gov. To learn more about Sjögren's syndrome and the Sjögren's clinic, visit www.nidcr.nih.gov. For NIH Radio, this is Lesley Earl— NIH...Turning Discovery Into Health®
About This Audio Report
Reporter: Lesley Earl
Sound Bite: Dr. Gabor Illei
Topic: sjögren’s syndrome, Sjogren, autoimmune disease, autoimmune disorder, exocrine gland, salivary gland, saliva, lacrimal gland, tears, dry eye, dry mouth, rheumatoid arthritis, arthritis, stiffness, swelling, fatigue
Additional Info: Sjögren's Syndrome