Sjogren’s Syndrome

Diagnosis

Sjogren’s syndrome can be challenging to diagnose because its signs and symptoms vary and may resemble other conditions. Some medications can also produce similar symptoms.

Several tests can help confirm the diagnosis and rule out other conditions:

Blood tests

Levels of different types of blood cells
Presence of antibodies commonly seen in Sjogren’s syndrome
Evidence of inflammatory conditions
Indicators of liver and kidney problems

Eye tests

Schirmer tear test: Measures tear production using a small piece of filter paper under the lower eyelid.
Slit lamp examination: An ophthalmologist examines the eye surface, sometimes using drops to detect corneal damage.

Imaging

Sialogram: An X-ray of the salivary glands after dye injection to assess saliva flow.
Salivary scintigraphy: A nuclear medicine test using a radioactive isotope to track saliva production in the glands.

Biopsy

Lip biopsy: A small sample of salivary gland tissue from the lip is examined for clusters of inflammatory cells indicative of Sjogren’s syndrome.

Treatment

Treatment depends on the areas of the body affected. Many people manage dry eyes and mouth with simple self-care, while others may require medications or procedures.

Medications

Decrease eye inflammation: Prescription eyedrops such as cyclosporine or lifitegrast may help with moderate to severe dry eyes.
Increase saliva production: Drugs like pilocarpine and cevimeline can stimulate saliva and sometimes tear production. Side effects may include sweating, abdominal pain, flushing, and increased urination.
Address specific complications: NSAIDs or other arthritis medications for joint symptoms; antifungal medications for yeast infections in the mouth.
Treat systemwide symptoms: Hydroxychloroquine may help with overall symptoms, and immunosuppressants like methotrexate can be prescribed if needed.

Surgery