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Sjogren’s Syndrome

What is Sjogren’s Syndrome?

Sjogren’s syndrome is a chronic autoimmune disorder in Singapore that primarily affects the tear-producing and salivary glands. This leads to reduced tear and saliva production, resulting in symptoms like dry eyes and dry mouth. It can also extend to affect other moisture-producing glands causing dryness in various areas, including the nose, throat, skin and vagina. While the disease can be mild in some cases, it can also be more pronounced and involve other organ systems, leading to arthritis, rashes, lung, kidney, and nerve involvement.   

Sjogren’s syndrome can present as either primary Sjogren’s syndrome when it occurs on its own, or as secondary Sjogren’s syndrome when it coexists with another autoimmune disorder like rheumatoid arthritis or systemic lupus erythematosus (SLE).

mouth dryness
Individuals with Sjogren’s syndrome often experience mouth dryness as a symptom

What causes Sjogren’s Syndrome?

Sjogren’s syndrome is a chronic autoimmune disease where the immune system mistakenly attacks the body’s healthy tissue and cells. In Sjogren’s syndrome, these immune cells attack the glands that produce tears and saliva, causing inflammation which leads to destruction of the glands. The exact cause of Sjogren’s syndrome is not fully understood, but it is believed to be primarily related to a combination of genetic and environmental factors. Some potential factors include:

  • Genetic predisposition: they may be a genetic component that makes some individuals more susceptible to developing Syndrome’s syndrome.
  • Environmental factors: viral infections such as the Epstein-Barr virus, B and hepatitis C virus may play a role in triggering the condition in genetically predisposed individuals.

It is important to note that while these factors are associated with developing Sjogren’s syndrome, the exact cause may be unique to you. 

What are the symptoms of Sjogren’s Syndrome?

The symptoms of Sjogren’s syndrome can vary from person to person. Common symptoms of Sjogren’s syndrome include:

  • Dry eyes: mucus glands in the eye become damaged in Sjogren’s syndrome, resulting in persistent dryness, irritation and gritty sensation in the eyes.
  • Dry mouth (xerostomia): a feeling of dryness or stickiness in the mouth, which can lead to difficulty swallowing or speaking.
  • Dryness in other areas: Sjogren’s syndrome can also cause dryness in the nose, throat, skin and vagina. This causes dry and itchy skin and the latter may cause discomfort during intercourse.
  • Fatigue: some individuals with Sjogren’s syndrome may experience persistent fatigue and tiredness.
  • Joint pain: joint pain, stiffness, and swelling can occur in some cases.
  • Salivary gland enlargement: swelling of the glands, particularly in front of the ears (parotid glands) and under the jaw (submandibular glands), affects 30-50% of individuals with Sjogren’s syndrome.
  • Oral issues: the lack of saliva can lead to dental decay, gum inflammation and disease, or mouth ulcers.
  • Systemic symptoms: some individuals may experience more widespread symptoms, affecting the lungs, kidneys and nervous system.
Sjogren’s syndrome symptoms
Sjogren’s syndrome is a complex condition with numerous symptoms affecting various body parts.

If you suspect you have Sjodren’s syndrome or are experiencing any of the symptoms mentioned above, make an appointment with Asia Arthritis Rheumatology Clinic today.

Who is at risk of Sjogren’s Syndrome in Singapore?

Sjogren’s syndrome can affect individuals of any age, gender and ethnicity. However, certain risk factors can make you more susceptible to this condition. These risk factors include:

How is Sjogren’s Syndrome diagnosed?

Diagnosing Sjogren’s syndrome can be a complex process that takes time before your rheumatologist can accurately determine if you have the condition.

Generally, the following steps are involved in the diagnostic process:

  • Clinical history: your rheumatologist will typically begin by discussing your medical history and symptoms. During this time, you can share if you are experiencing dry eyes, dry mouth, joint pain, fatigue or any other concerning symptoms.
  • Physical examination: a physical exam will assess specific signs associated with Sjogren’s syndrome (including dry eyes, dry mouth, swollen salivary glands, or joint tenderness).
  • Blood tests:  specific autoantibody tests can be used to detect Sjogren’s syndrome,  such as anti-SSA (Ro) and anti-SSB (La) antibodies.
  • Eyes examination: a simple Schirmer’s test will be performed, which measures the amount of tear formation using a strip of blotting paper. A referral to an ophthalmologist (eye specialist) may be made.
  • Biopsy: a small piece of tissue is removed from your lower inner lip and examined under a microscope to look for inflammation in the salivary glands. A biopsy is often the most definitive diagnostic test for this condition.
 blood test
Blood tests may be ordered to check for antibodies associated with Sjogren’s syndrome.
Schirmer’s test
A simple Schirmer’s test, which measures the amount of tear production using a strip of blotting paper. Photo credit: Survey of Ophthalmology Journal

What are the treatment options for Sjogren’s Syndrome in Singapore?

There is no cure for Sjogren’s Syndrome, but the symptoms can often be managed and controlled through various treatments and strategies to improve quality of life. The treatment plan varies based on the severity of your symptoms and any complications that may have arisen.

Common treatment options for Sjodren’s syndrome include:

  • Symptoms control: artificial tears, regular mouth rinses, lozenges or sips of water to stimulate saliva secretion. Skin moisturiser and vaginal lubricant to reduce dryness.
  • Medications: medications such as pilocarpine (stimulates saliva) or cevimeline (relieves dry eyes and mouth) may be prescribed to alleviate symptoms of dry mouth or dry eyes. Anti-inflammatory medications such as non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids may be prescribed to reduce joint pain and inflammation. Corticosteroids may be administered via joint injections. Other medications like immunosuppressive drugs may be prescribed for severe cases to suppress the immune system and control inflammation and organ involvement.
  • Dental care: regular dental check-ups and preventive care are crucial to manage oral health and prevent tooth decay and gum disease.
  • Managing systemic complications: if Sjogren’s syndrome affects your kidneys or lungs, your treatment plan may be directed at managing those complications.
  • Lifestyle adjustments: lifestyle changes such asusing a humidifier to combat dry air or practising good dental hygiene to prevent oral issues are some ways to alleviate Sjogren’s syndrome symptoms.

It is important to remember that the treatment plan for Sjogren’s syndrome is highly individualised.

Make an appointment with Asia Arthritis Rheumatology Centre where we prioritise our patient’s health by ensuring accurate diagnosis and personalised treatment.

Frequently Asked Questions

Can Sjogren’s syndrome be cured?

No, there is currently no cure for Sjogren’s syndrome. However, the right treatment plan specific to your unique needs helps to manage symptoms, improve your quality of life, and prevent complications associated with Sjogren’s syndrome.

Can I lead a normal life with Sjogren’s syndrome?

With proper management and treatment from a rheumatologist, you can lead a fulfilling life with Sjogren’s syndrome. While there may be challenges, symptom control and lifestyle adjustments can help you maintain a good quality of life.

Can Sjogren’s syndrome lead to other health complications?

Yes, Sjogren’s syndrome can lead to various health complications. This includes dental issues, lung problems, and an increased risk of lymphoma (a type of cancer that affects the lymphatic system, a part of the body's immune system). Regular medical care and symptom management are crucial to mitigate these risks.

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Dr Annie Law

Senior Consultant Rheumatologist
MB BCh BAO, MRCP (UK), MMed,
FAMS (Rheumatology)

Dr Annie Law is an experienced Senior Consultant Rheumatologist and Medical Director at Asia Arthritis & Rheumatology Centre.

She leads subspecialty SLE clinics, showcasing her dedication to lupus care. Dr Annie Law has been duly recognised for patient-oriented care, earning multiple awards. Her extensive education includes FAMS (Rheumatology) and MRCP (General Medicine). Actively involved in lupus research, she established a lupus database and contributed to paramount protein therapy discoveries. Dr Law is a committed medical educator, holding faculty positions and receiving accolades for her teaching. Her impactful contributions extend to the professional organisation for rheumatology in Singapore exemplifying deep commitment to advancing rheumatology knowledge.

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