What are the symptoms of Sjögren's syndrome?

Symptoms of Sjögren's Syndrome

Sjögren's syndrome primarily presents with dry eyes and dry mouth (sicca symptoms), along with systemic manifestations including extreme fatigue, joint and muscle pain, and potential involvement of multiple organs. 1, 2

Primary Sicca Symptoms

Oral Symptoms

• Dry mouth (xerostomia) 3, 1, 4
• Need for liquids to swallow dry foods 3
• Frequent sipping/drinking of water 3
• Burning sensation in the mouth 3
• Painful sores or red patches at corners of the mouth (angular cheilitis) 3
• Frequent dental cavities, particularly at the gumline 3, 4
• Teeth that chip, crack, or erode on surfaces 3, 5
• Gum inflammation or receding gums (gingivitis) 3
• Difficulty in swallowing 4

Ocular Symptoms

• Dry eyes (keratoconjunctivitis sicca) 3, 1, 2
• Sensation of foreign body in the eye 3
• Eye irritation, itchiness, or pain 3
• Light sensitivity 3
• Frequent use of eye drops for irritation or dryness 3
• Blurry vision or unexplained vision changes 3

Systemic Manifestations

Glandular Symptoms

• Swelling of glands in face or along jawline (parotid and submandibular glands) 3, 1

Musculoskeletal Symptoms

• Joint pain (arthralgias) 3, 1
• Muscle pain (myalgias) 3, 1

Skin and Mucous Membrane Symptoms

• Vaginal dryness (causing painful intercourse) 3
• Dry skin (causing itchiness or flaking) 3, 6
• Raynaud's phenomenon (fingers turning pale or blue in cold) 3

Neurological Symptoms

• Peripheral neuropathy (numbness, changed sensation, or burning pain in feet, legs, or hands) 3

Constitutional Symptoms

• Extreme fatigue 3, 1, 4

Less Common but Serious Manifestations

Pulmonary Involvement

• Dry, nonproductive cough (xerotrachea) 3
• Small airway disease 3

Lymphoproliferative Risk

• Approximately 5% risk of developing lymphoma 1, 7, 8
• Higher risk associated with decreased C4 levels at diagnosis 1, 7, 8

Other Potential Organ Involvement

• Kidney involvement 7, 2
• Liver involvement 7, 8
• Nervous system involvement 7, 2
• Vasculitis 7, 6

Important Clinical Considerations

• Symptoms may develop gradually over time, often leading to delayed diagnosis 5, 9
• Women are much more commonly affected than men (20:1 ratio) 1, 8
• Symptoms can occur as primary Sjögren's syndrome or secondary to other autoimmune diseases like rheumatoid arthritis, scleroderma, or lupus 1, 6
• The presence of anti-SSA/Ro antibodies is a key diagnostic marker 1, 9
• Symptoms should prompt further serologic evaluation and/or rheumatology consultation 3, 1