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Sjögren’s disease, previously called Sjögren’s syndrome, is an autoimmune disease. In autoimmune diseases, the immune system mistakenly attacks healthy parts of the body. Sjögren’s mainly affects glands that make moisture, which can lead to symptoms like dry eyes and dry mouth. It’s common for Sjögren’s to occur alongside one or more other autoimmune diseases.
Around half of people with Sjögren’s have another autoimmune disorder. Until recently, the term for Sjögren’s disease that occurs alongside another autoimmune disease was secondary Sjögren’s disease. (In contrast to primary Sjögren’s, which occurs without any other autoimmune disease.) This term is now considered outdated.
When you have Sjögren’s disease and another autoimmune condition at the same time, no matter which developed first, many researchers now call it associated Sjögren’s. For example, doctors might say, “Sjögren’s associated with lupus.”
Researchers like those at the Sjögren’s Foundation consider the term “secondary” to be misleading. It implies that Sjögren’s disease is less concerning than the other autoimmune diseases it’s associated with, and that it occurs after or as a symptom of another disease. In fact, Sjögren’s disease can be quite severe and greatly impact your quality of life. People with both Sjögren’s and another autoimmune disease often develop Sjögren’s first.
Sjögren’s disease is strongly associated with other autoimmune conditions, but it can also occur on its own. Sjögren’s has its own causes, symptoms, and risks, whether you have associated Sjögren’s or not. Sjögren’s is not considered curable. That said, some treatments can help reduce symptoms like dry eyes, dry mouth, and other dryness.
The most common diseases that occur with Sjögren’s are rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE, the most common form of lupus). RA is a chronic autoimmune disease where the body attacks its own tissues, especially the lining of the joints, causing pain and swelling. Systemic lupus erythematosus affects many systems across the body, causing tissue damage. It can affect the skin, joints, kidneys, and other organs. Associated Sjögren’s may appear before, after, or at the same time as the other condition.
Researchers aren’t exactly sure what causes Sjögren’s, but they know it can be genetic — you are more likely to have it if one or both of your parents have it. And they’ve also identified that some cases may be triggered by a virus or infection. Viruses that have been linked to Sjögren’s include hepatitis C, Epstein-Barr virus, cytomegalovirus, and HTLV-1 (human T-cell leukemia virus type 1).
Someone with another rheumatic or autoimmune disorder is more likely to develop Sjögren’s than someone who does not have another autoimmune condition. This risk also runs in the opposite direction — having one autoimmune disease usually increases the risk of developing others, regardless of which one develops first. Around 25 percent of people with autoimmune diseases develop one or more additional autoimmune diseases. One study found that 4.4 percent of people with Sjögren’s developed another autoimmune disease.
According to Cleveland Clinic, you are also more likely to get Sjögren’s if you are female, if you are between 45 and 55 years old, and if you have a family history of Sjögren’s. More than 90 percent of people with Sjögren’s are female.
Whether or not you have another autoimmune condition, Sjögren’s disease often causes:
In more severe cases of Sjögren’s, you might experience:
When you have associated Sjögren’s, you may experience Sjögren’s symptoms and symptoms of another disease at the same time. If you have lupus or RA, some symptoms of these conditions overlap, and it may be difficult to tell which condition is causing which symptoms, or if some symptoms may be caused by both conditions.
Shared symptoms between Sjögren’s, SLE, and RA that might lead to diagnosis could include:
When diagnosing associated Sjögren’s, your doctor may need to do multiple tests to determine the cause of your symptoms.
Some of these tests include:
Your doctor may also test for certain viruses that can be mistaken for Sjögren’s.
When Sjögren’s appears alongside other autoimmune conditions, especially lupus and RA, it can worsen symptoms like fatigue, affect how the diseases progress, and increase the risk of lymphoma.
In Sjögren’s, the immune system becomes overactive. Immune cells attack moisture-producing glands and other tissues, causing inflammation and damage. This buildup of immune cells in the salivary and tear glands causes most of the symptoms and may also increase the risk of lymphoma. It can also contribute to ongoing inflammation.
Other rare but possible complications of Sjögren’s and associated Sjögren’s include:
If you have one autoimmune disease, it’s fairly common to have another one. For any given person, a treatment plan needs to take into account the full picture of their health and symptoms.
Treatments for associated Sjögren’s often include:
No matter what form of Sjögren’s you have, it’s important to remember that many people have found relief with the right treatments. If you aren’t finding a treatment that works for you, consider seeing a rheumatologist or a Sjögren’s specialist.
On MySjögrensTeam, people share their experiences with Sjögren’s disease, get advice, and find support from others who understand.
Do you have Sjögren’s and other autoimmune conditions? How do you manage them? Let others know in the comments below.
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