Clinical Aspects of Sjögren’s

Sjögren's is an autoimmune inflammatory disorder of the exocrine glands, particularly affecting lacrimal and salivary glands, which can adversely affect quality of life (QOL) and carry a high illness and financial burden. Hallmark symptoms are dry mouth and eye, often in conjunction with profound fatigue and neurocognitive dysfunction. However, dry mouth and/or dry eye may not be present at disease initiation, which contributes to the diagnostic challenge and under recognition despite high prevalence of the disease. Various extraglandular manifestations, such as neuropathy, gastrointestinal dysmotility, arthralgia, and photosensitive skin rashes, may be presenting signs. The sentinel feature of the disease is lymphocytic, predominantly CD4+ T cells and infiltration of target tissue. Sjögren's can be the primary condition (primary Sjögren's) or co-occur with another autoimmune disease (secondary Sjögren's). Primary Sjögren's is more frequent in women than men, but it may be underrecognized in men and children. Early, accurate diagnosis of Sjögren's can help prevent or ensure adequate treatment of the many complications associated with the disease. With a proactive and multidisciplinary treatment plan, the QOL of Sjögren's patients can be significantly improved and the burden of illness reduced.