Lupus Site - a guide for lupus patients and their families

In 1933, Henrik Sj�gren (pronounced show-gren) described some symptoms common to a group of patients - dry eyes (keratoconjunctivitis sicca), dry mouth (xerostomia), & arthritis. In the late 60s, doctors found that many patients with these symptoms had an autoimmune process. Sj�gren's syndrome can be part of many autoimmune diseases, including lupus, or may exist by itself (primary Sj�grens). At least 10% of lupus patients have Sj�gren's.

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The symptoms

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The eyes usually gritty & scratchy, & are sometimes very sensitive to light. A dry mouth can make swallowing dry foods difficult, & can cause tooth decay & dental hygiene problems. Other mucous membranes may be dry including the lining of the stomach and vagina. Joint pains can also be present.

Sj�gren's patients often have very high levels of autoantibodies, especially the anti-Ro antibody.

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Diagnosis

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Sj�gren's can be diagnosed with the Schirmer's test which involves putting a very small strip of blotting paper in each eye, to measure the amount of tears produced. Another test is the Rose Bengal staining test, which stains the cornea to check for pitting or areas of scarring.

Patients who have both lupus & Sjogren's are more likely to have the autoantibodies anti-SSA/Ro & anti-SSB/La.

Sometimes a lip biopsy is necessary to confirm the diagnosis.

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Treatment

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The treatment is usually symptomatic. Dry eyes can be treated with artificial tears, dry mouth with artificial saliva, or just chewing gum or drinking fluids. There has been some evidence to show that Plaquenil (hydroxychloroquine) can be helpful.