Sjogren's Syndrome: Indications It Could Be More Serious

February 9, 2022

Sjogren's syndrome, otherwise known as dry eye or dry mouth syndrome, is an autoimmune condition in which the immune system mistakenly attacks the cells responsible for producing tears and saliva. It is also often accompanied by other autoimmune conditions, such as rheumatoid arthritis. Women over the age of forty are most at risk of developing this condition. Sjogren's syndrome is diagnosed through a variety of tests, including biopsies, blood tests, and eye tests. Treatment for this condition focuses on symptom relief and shifts based on what parts of the body are affected.

Here are several indications Sjogren's syndrome might be more than just dry eyes and mouth.

Inflammation Of The Spinal Cord

Some patients with Sjogren's syndrome may develop myelitis, which is characterized by inflammation of the spinal cord. In addition to being painful, it may cause weakness, difficulty using the bathroom, and numbness throughout the body. Many patients dealing with Sjogren's syndrome are misdiagnosed with multiple sclerosis at first, as inflammation of the spinal cord is an incredibly common symptom in both of these diseases. However, the treatments for both Sjogren's syndrome and multiple sclerosis are very different and may cause a flare-up or worsen the conditions if not treated properly.

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Other Autoimmune Disorders

As with many autoimmune diseases, having one autoimmune disorder like Sjogren's syndrome often greatly increases an individual's risk of developing more. Patients who suffer from Sjogren's syndrome are at a particularly high risk of developing an autoimmune condition called Devic's disease, which causes significant inflammation in the nerves connecting the eyes to the brain. This condition can also cause myelitis, which once again makes it easy to confuse with multiple sclerosis, thus enforcing why close attention must be paid to symptoms. Weakness associated with Devic's disease may be more severe than in other autoimmune conditions.

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Muscle Weakness Or Imbalance

Experiencing imbalance in the muscles or muscle weakness can be a sign of a more serious condition linked with Sjogren's syndrome called mononeuritis multiplex, which occurs when there is inflammation in a patient's smaller blood vessels. This condition is otherwise known as a stroke of the nervous system, as the muscles and nerves surrounding affected blood vessels may stop receiving blood and oxygen. Mononeuritis multiplex can be detected through nerve-conduction tests. Treatment for this condition and symptom often includes select medication and immunosuppressant drugs that aim to reduce inflammation of the blood vessels.

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Irregular Heartbeat

Neuropathy occurs when there is inflammation or damage to the peripheral nerves, and it has been known to affect patients with Sjogren's syndrome. Neuropathy symptoms are described as coldness, numbness, or a burning sensation in the skin. It may also cause imbalance and weakness in muscles. Because Sjogren's syndrome may target nerves that are not always tested on routine nerve conduction tests, neuropathy can be hard to detect. In some cases, Sjogren's syndrome may cause autonomic neuropathy, which may result in an irregular heartbeat, gastrointestinal disorders, and respiration problems as well.

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Numbness Of The Face

Sjogren's syndrome may be an underlying cause of a condition known as trigeminal neuralgia, which occurs when there is numbness or burning of the face. In some cases, the condition may worsen and develop into what is known as glossopharyngeal neuralgia. Patients who experience glossopharyngeal neuralgia report symptoms like agonizing mouth or facial pain, along with severe difficulty swallowing. These symptoms may exist with other neuropathies in the body. Reports indicate up to twenty percent of patients with low-grade neuropathy may also be dealing with trigeminal neuralgia.

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Disruption Of Normal Kidney Function

In a 2001 study by the Nephrology Dialysis Transplantation organization of Europe, it was concluded kidney function could frequently become impaired due to Sjogren's syndrome. Symptoms directly related to this condition include kidney stones, nocturia, and polyuria. The same type of inflammation in the kidney caused by Sjogren's syndrome can also affect other organs in the body, such as bronchitis in the lungs or cirrhosis of the liver. Correct treatment of Sjogren's syndrome will slow the onset of kidney disease, which highlights the importance of a prompt diagnosis. The reported instances of kidney impairment or disease vary incredibly widely. The most common causes of kidney disease are hereditary or related to high blood pressure and diabetes.

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Cognitive Impairment (Brain Fog)

Approximately eight to forty percent of Sjogren's syndrome patients will also experience a disruption in the central nervous system or spinal cord. Specific cognitive symptoms relating to Sjorgen's syndrome include cognitive dysfunction, encephalopathy, myelopathy, optic neuropathy, and even seizures. Although another ailment usually causes this type of symptom, it is best to determine what is causing them. Motor function impairment, as well as sensory impairment, can be observed in up to fifty-five percent of patients with Sjogren's syndrome. Progressive weakness or even paralysis can occur if the symptoms are not treated properly. Keeping a diary of occurrences of brain fog, or the inability to function at the normal cognitive level is a good start in determining what is causing the impedance. Although Sjogren's syndrome can produce these types of symptoms, many other ailments can also cause them. A thorough consultation with a health professional is critical.

Tooth Decay

Sjogren's syndrome is known to dry out the mouth, creating a cotton-mouth feeling which can make it difficult to swallow or speak. Cavities are more likely to develop due to dryness of the mouth and the inability to protect the teeth with saliva. Dentists are among the first to spot the symptoms of Sjogren's syndrome because many of the early signs will manifest inside the mouth. There are many sugar-free snacks and gums available that will stimulate the production of saliva. Many patients with Sjogren's syndrome will visit the dentist first and complain of a dry mouth or excessive decay and will then visit a physician to deal with joint pain and fatigue. Patients with excellent dental hygiene may also experience teeth and mouth pain.

The Gastrointestinal System Is Performing Poorly

The lack of saliva in those with Sjogren's syndrome cause a wealth of problems for the gastrointestinal tract and the digestion and breaking-down of foods and acids. The lack of saliva can impede the clearing of acid from the stomach which can result in acid reflux. This condition can also cause abdominal pain due to the build-up of acid, and some symptoms are even appendicitis-like. Problems with the esophagus can lead to some dry foods being unable to be eaten by individuals with Sjogren's syndrome. Specifically, patients with this condition are at increased risk for a delayed gastric emptying; this causes nausea, upper abdominal discomfort, and vomiting. In very rare cases, Sjorgen's syndrome patients can develop pancreatitis (acute or chronic) as well as malabsorption due to pancreatic insufficiency.

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Swollen Salivary Glands

As we know with Sjogren's syndrome, the immune system attacks the body's tissues, and it often occurs alongside other autoimmune diseases. When swollen salivary glands are a symptom of Sjogren's syndrome, they most commonly include the glands in front of the ears and behind the jaw. Though the condition is caused by an underlying autoimmune response, swollen glands are often a sign of an infection. Patients who experience swollen glands alone may have a virus or bacteria inside the affected gland. In Sjogren's syndrome, the reduced amount of saliva allows bacteria to grow in the gland. Other common causes of swelling are severe dehydration, a blockage in the gland, or poor oral hygiene.

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Eye Irritation And Dryness

Dryness in the eyes is one of the main symptoms of Sjogren's syndrome. Eye irritation and dryness tend to go hand-in-hand. A patient's eyes might burn and itch. Some have reported a 'gritty' feeling, like they have sand stuck in their eyes. The dryness occurs because the immune system attacks the moisture-secreting glands and mucous membranes of the eyes. With a reduced ability to create moisture, the eyes aren't receiving the hydration they need. In an ordinary and healthy individual, every time they blink, invisible tears and moisture coat the eyes and surrounding area. But Sjogren's syndrome patients don't have a sufficient amount of this moisture.

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Mouth Sores And Swelling

Individuals with Sjogren's syndrome may also experience mouth sores and swelling. Sores might be located inside the cheeks, or on the roof of the mouth, gums, or tongue. The sores develop because the mouth lacks sufficient saliva to lubricate and clean itself. Some patients with Sjogren's syndrome who are dealing with a dry mouth will have split skin or sores around the corners of their mouths. It's also common for the lips to become cracked and dry. The sores can be painful and may make it difficult to chew and swallow food. Swelling may be an indication of an infection. Patients dealing with this symptom sometimes develop a yeast infection in the mouth.

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Changes In Or Loss Of Taste

Researchers have established individuals with Sjogren's syndrome are more likely to develop taste disorders. These may include diminished taste, also called hypogeusia; altered taste, also called dysgeusia; and the loss of taste, also called ageusia. Like other mouth-related complications, the issue can be attributed to a lack of saliva. For an individual to fully taste the flavors in food, the food must be fully coated in saliva. In addition, saliva protects the taste buds and other oral structures from damage. Without this protective coating, taste buds may erode or become injured. Saliva also carries food across the tongue to allow the taste buds to experience it fully. It's important for patients with taste disorders to receive a medical evaluation, as these changes can also be caused by other medical conditions or medications.

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Gum Disease

Sjogren's syndrome doesn't cause gum disease by itself, but the disease's progression makes patients more susceptible to it. In addition, Sjogren's syndrome patients may also have more cavities than the average individual. Saliva is necessary to prevent the teeth from decaying by cleaning away food and neutralizing acid. If the mouth isn't producing enough saliva, the remaining acids and bits of food can cause plaque buildup. For this reason, individuals with Sjogren's syndrome need to pay close attention to their oral hygiene and dental care procedures. The main symptoms of gum disease include bleeding, tender or swollen gums, loose teeth, pus between the teeth and gums, persistent bad breath, and mouth sores. If left untreated, the condition might cause individuals to lose their teeth.

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