Sjögren's disease – also known as Sjögren's syndrome – is a chronic autoimmune condition in which the immune system attacks the body's moisture-producing glands. This primarily affects the glands that produce tears and saliva, leading to persistent dry eyes and dry mouth. However, Sjögren's disease is a systemic condition and can affect other parts of the body including the joints, skin, kidneys, lungs, and nervous system.
Sjögren's disease can occur on its own (primary Sjögren's disease), or alongside another autoimmune condition such as rheumatoid arthritis, lupus, or scleroderma (secondary Sjögren's disease).
There is no cure for Sjögren's disease, but symptoms can be managed effectively with a combination of medications, self-care strategies, and regular specialist monitoring.
How common is Sjögren's Disease?
Sjögren's disease is one of the more common autoimmune conditions, though it is frequently underdiagnosed due to its overlap with other conditions and the tendency to attribute symptoms like dry eyes to age or environmental factors. Estimates suggest it affects around 0.1–0.6% of the population globally.
Around 90% of people with Sjögren's disease are female. It most commonly develops between the ages of 40 and 60, though it can occur at any age. People with a family history of autoimmune conditions are at higher risk.
The hallmark symptoms are dryness of the eyes and mouth, but Sjögren's disease affects the whole body.
Common symptoms include:
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- Dry eyes – a gritty, burning, or itchy sensation; eyes that feel uncomfortable or appear red; blurred vision or sensitivity to light
- Dry mouth – difficulty chewing, swallowing, or speaking; altered taste; a sticky or parched feeling in the mouth
- Swelling and tenderness of the glands around the face, neck, armpits, or groin
- Fatigue – persistent tiredness that can be significant and disabling
- Joint pain, stiffness, and swelling
- Dry skin or skin rashes
- Dryness of the nose, throat, or ears
- Vaginal dryness
- A persistent dry cough
In more severe cases, Sjögren's disease can cause inflammation of internal organs including the kidneys, lungs, and liver, or affect the nervous system.
A small number of people with Sjögren's disease have an increased long-term risk of developing lymphoma (lymph node cancer), which is why regular follow-up with a specialist is important.
The exact cause is not fully understood.
It is thought to involve a combination of factors:
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- Genetics – Sjögren's disease appears to run in families and is associated with certain genes, suggesting a hereditary component
- Immune system dysfunction – the immune system mistakenly produces antibodies (particularly anti-Ro/SSA and anti-La/SSB) that attack the body's own moisture-producing glands
- Environmental triggers – bacterial or viral infections may trigger the onset of Sjögren's disease in genetically susceptible individuals
- Hormonal factors – the strong female predominance and typical onset around menopause suggest that hormonal changes may play a role
Sjögren's disease is not contagious and cannot be passed from person to person.
Sjögren's disease can be difficult to diagnose because its symptoms – particularly dry eyes and dry mouth – are common and can be caused by many other conditions or medications.
Diagnosis involves a combination of:
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- A detailed review of symptoms, their duration, and any associated autoimmune conditions
- A physical examination including assessment of the eyes and glands
- Blood tests – including anti-Ro/SSA and anti-La/SSB antibodies (the most specific markers for Sjögren's disease), antinuclear antibody (ANA), rheumatoid factor, and blood count
- Schirmer's test – strips of blotting paper are placed at the lower eyelid to measure tear production
- Eye examination – including the use of special dyes to assess eye surface damage
- Salivary gland imaging – to evaluate gland structure and function
- Lip biopsy – a small piece of salivary gland tissue is taken from the lower lip and examined under a microscope to look for characteristic inflammation
Referral to a rheumatologist and often an ophthalmologist is recommended. Dry mouth and dry eyes are also common side effects of many medications, including antidepressants and blood pressure drugs, which should be ruled out during assessment.
Treatment is tailored to the individual and depends on which symptoms and organs are affected.
The goals are to relieve dryness, manage inflammation, and protect organs.
Symptomatic treatments for dryness
Managing dryness is a central part of treatment and often involves over-the-counter products used consistently:
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- Artificial tears (eye drops) and lubricating eye ointments for dry eyes
- Artificial saliva sprays, gels, lozenges, and mouth rinses for dry mouth
- Nasal sprays and vaginal lubricants for dryness in those areas
- Preservative-free moisturiser for dry skin
Medications
Hydroxychloroquine (Plaquenil) reduces immune system activity and is commonly prescribed for fatigue, joint pain, and systemic symptoms. Pilocarpine stimulates the moisture-producing glands to increase saliva and tear production for dry mouth and dry eye.
NSAIDs, corticosteroids, and immunosuppressants such as methotrexate, azathioprine, or mycophenolate are used depending on disease severity. Rituximab may be used in severe cases unresponsive to other treatments.
Regular dental visits are essential — reduced saliva significantly increases the risk of decay and oral thrush. Regular ophthalmology review is recommended for significant eye involvement.
The following specialty medications are available at Ace, a specialty pharmacy for Sjögren's Disease.
Note: Most first-line symptom management for Sjögren's disease (artificial tears, artificial saliva) involves non-prescription products not listed here.
With Ace, you’ll benefit from:
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- Expert Support — Our dedicated team of health concierges is always available to answer your questions, provide guidance, and help you navigate your condition with confidence.
- Specialty Medication — We offer a wide range of specialty medications and support services, designed specifically for those living with chronic illnesses. Whether you’re looking for help managing a specific condition, or simply need access to the medications you need, we’ve got you covered.
- A Wide Range of Conditions — From diabetes to heart disease, and everything in between, we help manage a variety of special condition
Take control of your health and well-being, and start your journey to better health with Ace today.
Sjögren's-Specific Support
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- Sjögren's Australia – Australian patient support organisation for Sjögren's disease
- Lupus Association of NSW – Sjögren's Syndrome – information and support for people with Sjögren's in NSW
Broader Arthritis and Autoimmune Support
Clinical & Research Resources
