Clinical manifestations of Sjögren's syndrome: Exocrine gland disease
- Alan N Baer, MD, FACP
Alan N Baer, MD, FACP
- Associate Professor of Medicine
- Director, Jerome L. Greene Sjogren’s Syndrome Center
- Johns Hopkins University School of Medicine
Sjögren’s syndrome (SS) is a chronic inflammatory disorder characterized by diminished lacrimal and salivary gland function. SS may occur alone (primary form) or in association with a second well-defined rheumatic disease (secondary form). The most common disease associated with secondary SS is rheumatoid arthritis.
In primary or secondary SS, decreased exocrine gland function leads to dry eye and dry mouth [1,2]. In addition, a wide variety of other disease manifestations can occur in SS. The clinical manifestations of SS are divided into the exocrine gland features and the extraglandular disease features .
The clinical manifestations of exocrine gland disease in SS will be reviewed here. The extraglandular manifestations, the classification and diagnosis, and the treatment of both sicca and extraglandular manifestations are discussed separately. (See "Clinical manifestations of Sjögren's syndrome: Extraglandular disease" and "Diagnosis and classification of Sjögren's syndrome" and "Treatment of dry eye in Sjögren's syndrome: General principles and initial therapy" and "Treatment of dry mouth and other non-ocular sicca symptoms in Sjögren's syndrome" and "Treatment of systemic and extraglandular manifestations of Sjögren’s syndrome".)
Major features — The exocrine gland involvement is primarily dry eye disease and salivary hypofunction, but other manifestations may also be seen. The exocrine manifestations include:
●Dry eye disease – The ocular symptoms of dry eyes are irritation, grittiness, and a foreign body sensation. Signs include diminished tear flow as measured by the Schirmer test, ocular surface staining with vital dyes, and increased tear osmolarity.
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- Major features
- Pathogenesis and histopathology of exocrine disease
- DRY EYE
- DRY MOUTH
- Clinical and diagnostic features
- - Oral candidiasis
- SALIVARY AND LACRIMAL GLAND ENLARGEMENT
- GENITOURINARY MANIFESTATIONS IN WOMEN
- UPPER AIRWAYS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS