Sjogren's syndrome is a chronic inflammatory disease of unknown aethiology. It is characterized by decreased secretion of salivary and lacrimal glands, which induces
keratoconjunctivitis sicca and
xerostomia.
Sjogren's syndrome is a central
autoimmune disease, and it has characteristics of both organ-specific and generalized
autoimmune diseases. It can exist as a primary disease or is associated with other
autoimmune diseases (most freyuently with
systemic lupus erythematosus or
rheumatoid arthritis) and is classified as a secondary
Sjogren's syndrome. The aethiology is multifactorial, and it has not yet been completely explained. In the pathogenesis of the disease the important role have
genetic predisposition, chronic oestrogen stimulation, end
viral infections, especially of the herpes virus group (EBV, CMV, HHV6) and retroviruses. In the clinical picture
xerostomia, xerophtalmia and non-erosive
arthritis are the most common features, with the whole spectrum of extraglandular manifestations of respiratory, gastrointestinal, skin, and haematologic, neurologic and endocrinologic disturbances. Pathohistological findings of minor labial salivary gland lymphocyte infiltration is the most specific and the most sensitive diagnostic criterion of
Sjogren's syndrome. The diagnosis of
keratoconjunctivitis sicca is made by Schrimer's test,
Rose bengal dye staining and by the "tear break up time". Differential diagnosis of
Sjogren's syndrome includes an extremely large number of various pathologic states. The treatment of
Sjogren's syndrome consists of symptomatic treatment of dry mucosas (
artificial tears, etc.) and also of antiinflammatory drugs,
glucocorticoids, immunosuppressive drugs.
Plasmapheresis and
intravenous administration of
immunoglobulins are used for immunosuppression in these patients.