Sjogren’s Syndrome (SS) is an autoimmune disorder that affects anywhere from 0.5% to 3% of the population, making it one of the most common autoimmune diseases. For many patients, SS presents only symptoms of dry eye and/or dry mouth, though these can be very troublesome. For others, SS progresses, bringing more systematic symptoms.
There are a number of symptoms which affect SS patients, though not all patients will experience all symptoms. In addition, most SS patients suffer periods known as “flares”, where their symptoms will intensify for a period of days or weeks.
Typical SS symptoms include:
- Dry eyes – This is often felt as grittiness, as if there is a small object that won’t come out. Patients cannot comfortably wear contacts. In particularly bad cases, the dryness causes constant eye pain.
- Dry mouth – Patients are unable to generate saliva due to inflammation in their sublingual (front) and/or parotid (back) glands. Because saliva plays an important role in cleaning and protecting teeth, dry mouth can cause a variety of dental issues, including cavities and tooth decay.
- Fatigue – Fatigue is often considered the most life-altering symptom by SS patients. This is caused by inflamation from immune activity. The intensity varies, from simply needing more sleep, to flu-like tiredness, to an inability to even get out of bed. Intense fatigue can make it difficult for SS patients to work or socialize. Fatigue is often exacerbated during flares, and is one of the most difficult symptoms to treat.
- Joint & muscle pain – SS patients commonly feel aches in their joints, muscles, and connective tissue. Like fatigue, it is caused by inflamation from immune activity. The pain can affect major joints, such as knees, elbows, hips, and shoulders, and minor joints, such as fingers. Connective tissue pain often affects the back and shoulders.
There are also a number of less common, but often more serious symptoms that affect SS patients. These symptoms include:
- Skin & nail symptoms – SS can case a number of skin symptoms, including dry skin, itchiness, and rashes (similar to lupus). SS patients are also more susceptible to nail problems, such as fungal onychomycosis.
- Sinus issues – Many SS patients experience dry sinuses, which can lead to bloody noses and sinus discomfort. They also find themselves more prone to sinus infections, and may suffer from sinus congestion and drainage, particularly during flares.
- Peripheral neuropathy – This usually manifests as a buzzing or tingling sensation, often in the legs, feet, or lips. The sensation may intermittent or constant, mild or very painful. A neurologist can help diagnose and treat more problematic cases.
- Lymphoma – SS patients are approximately 9 times more likely to develop non-Hodgkin’s lymphoma than the general population. While this still equates to less than a 2% chance, SS patients should be especially mindful of lymphoma symptoms, including weight loss, swollen lymph nodes and fevers.
- Other autoimmune disorders – Many SS patients have existing autoimmune conditions, such as rheumatoid arthritis or lupus, and develop SS as a further complication (this is known as “secondary” Sjogren’s Syndrome). Those with primary SS can are at a higher risk of developing other autoimmune disorders, including Hashimotos thyroiditis, celiac disease, and vasculitis.
- Nervous system disorders – Fibromyalgia and chronic fatigue sydrome/myalgic encephalomyelitis are generally regarded as nervous system disorders that result in significant aches, pains, and high degrees of fatigue. As these symptoms can also be caused by SS, it takes a skilled doctor to diagnose them. On the other side of the coin, many SS sufferers are incorrectly diagnosed as having fibromyalgia or CFS.
- Organ damage – Some SS patients suffer from dangerous systemic manifestations of SS, where their immune systems attack their lungs, liver, or kidneys. These symptoms must be treated aggressively with corticosteroids (such as prednisone) and immunosuppressants.
- Other issues – as a systematic autoimmune disorder, SS can affect patients in a myriad of different ways. If you are experiencing other strange symptoms, talk to your doctor, as they may be related to your Sjogren’s Syndrome.
Personally, I have experienced all of the common symptoms, along with skin, nail, sinus, and neuropathy issues. Luckily, none are to such a degree that I cannot work or socialize (outside of flares, during which I must usually rest).
For information about treating each of these symptoms, see the Treatments section.