As many as four million people in the U.S. have Sjögren's syndrome. More than 90% of them are women. The disease can affect people of any race or age, although the average age of onset is in the late 40s.
Certain laboratory tests also suggest that dry eyes and mouth are caused by autoimmune mechanisms. Examples include the presence of auto-antibodies in the blood, known as anti-SSA or anti-SSB (also called anti-Ro or anti-La).
Biopsy of the inner lip (performed in some cases to prove the diagnosis of primary Sjögren's syndrome). The biopsy may show inflammation that is damaging salivary glands.
Secondary Sjögren's syndrome is generally diagnosed when someone with an established autoimmune disease, such as rheumatoid arthritis or lupus, develops extreme dryness of the eyes and mouth. This diagnosis only rarely requires a lip biopsy.
There is no cure for Sjögren's syndrome, but it can be treated and controlled. The goals of treatment are to decrease discomfort and reduce the harmful effects of dryness. The type of treatment prescribed will be tailored to each patient's symptoms and needs. The following are some of the main methods of treatment for Sjögren's syndrome.
Good oral hygiene. Good mouth care may not prevent a dry mouth, but it helps prevent infection and cavities. Toothpastes and oral gels are available for people with dry mouth symptoms. These products contain low doses of peroxide. (High amounts can cause more severe dryness.) These products also may have antibacterial action to reduce the severity of dental cavities over a long period of time.
Increasing eye moisture. Dry eyes are mainly treated with the use of artificial tears, and a wide variety of products are available. Artificial tears must be used regularly and more often in dry environmental conditions such as on airplanes, in air-conditioned buildings, and on windy days.
While artificial tears are helpful, they often do not last long enough. Thicker preparations are available that last longer. These often are used at bedtime because they sometimes cause blurry vision. Eye drops containing cyclosporine (Restasis) treat inflammation in the glands around the eyes and may help to increase tear production. Surgery to slow the disappearance of tears by blocking or sealing the tear ducts is another treatment option for more severe cases when artificial tears are not sufficient.
For patients with generalized symptoms, particularly when the disease affects internal organs (including the gastrointestinal system, kidneys, brain, or spinal cord), high doses of immunosuppressive drugs may be necessary. These include medicines such as prednisone and, rarely, chemotherapy-type medications such as methotrexate.