• Clinical science

Sjogren syndrome


Sjogren syndrome is a chronic inflammatory autoimmune disease that occurs mainly in middle-aged women. The cause of primary Sjogren syndrome is unknown, whereas secondary Sjogren syndrome is associated with underlying autoimmune diseases (e.g., rheumatoid arthritis). As the immune system mainly attacks lacrimal and salivary glands, patients typically present with xerophthalmia (dry eyes) and xerostomia (dry mouth), the combination of which is also known as sicca syndrome. The disease may also involve the skin, joints, internal organs, and nervous system. It is diagnosed via the detection of autoantibodies (anti-SSA/Ro, ANA) and salivary gland biopsy. Management focuses on supportive measures and, in more severe cases, immunosuppressants.


  • Sex: > (∼ 9:1) [1]
  • Age of onset: typically 40–60 years [1]

Epidemiological data refers to the US, unless otherwise specified.



Clinical features

Glandular symptoms

Extraglandular symptoms

The classical presentation is a middle-aged woman with dry eyes and a dry mouth, accompanied by rheumatoid arthritis or systemic lupus erythematosus



Sjogren syndrome is diagnosed based on the typical clinical features and is confirmed via detection of specific antibodies and a pathologically low tear production. Biopsy of the salivary gland is the most accurate test, but is not needed to establish the diagnosis.

Laboratory tests

Eye examination


  • Method: usually taken from the labial salivary glands
  • Findings

Ultrasound of the parotid gland

  • Findings
    • Honeycomb or cloud-like structure of the glandular parenchyma
    • Alternating hypoechoic areas and band-like hyperechoic septa and cysts



  • Secondary Sjogren syndrome: treat the underlying disease
  • For dry mouth
  • For dry eyes
    • Avoid dry environments (e.g., shield eyes from wind, keep air humid)
    • Artificial tears
    • In moderate disease: topical immunosuppression (e.g., cyclosporine); , lubricants
  • Treatment of extraglandular disease: depends on the specific manifestation



Individuals with Sjorgen syndrome have an increased risk of developing MALT lymphoma.


We list the most important complications. The selection is not exhaustive.