Some patients with RA may develop dry eyes and a dry mouth, but these are not unusual symptoms linked only with this disease. Indeed, nearly one third of all elderly people—with or without RA—will report dry eyes and dry mouth to their physician. Symptoms of dryness can result from the aging process or from taking common medications, such as antidepressants, beta blockers, diuretics, and antihistamines. Alternatively, these symptoms may be the manifestation of a disease that occurs in approximately 10% to 15% of patients with RA, called Sjogren's syndrome (SS). This syndrome is named after the Swedish eye doctor who first described it, Dr. Henrik Sjogren's (pronounced “show-grin”).
Like RA, SS is a chronic autoimmune disorder. Indeed, it is one of the most prevalent autoimmune disorders, affecting as many as 4 million Americans. It strikes both men and women, but affects women in disproportionate numbers: Approximately 90% of all people with SS are female. The men who develop this disorder typically have milder disease. The syndrome usually develops between a person's thirties and forties, but has been reported in all age groups. Approximately 50% of patients with SS have RA or another rheumatological condition, such as lupus or systemic sclerosis. In people with RA, the symptoms of SS tend to develop five to ten years after the arthritic symptoms. The cause of SS is unknown.
Autoimmune disorder
A disorder that results when the body's tissues are attacked by its own immune system. Rheumatoid arthritis and systemic lupus erythematosus are examples of autoimmune disorders.
Whereas a person's immune cells attack the joints in RA, the immune cells attack and destroy the glands that produce tears and saliva in SS. As a result, the hallmark symptoms of this syndrome are dry mouth and dry eyes. These symptoms tend to become worse with age.
Patients with SS complain of dry eyes that may become red, itchy, and painful. The most common complaint is a gritty or sandy sensation in the eyes. These symptoms tend to worsen throughout the day. The eyelids may become inflamed. In the morning, the eyelashes can become matted (stuck together), making it difficult to open the eyes.
In addition, SS affects the mouth. Patients may complain of their tongue sticking to the roof of their mouth or an inability to eat dry food, such as crackers. Speaking may also be more difficult because of dryness. Affected individuals may mention that they need to keep a glass of water by their bedside because they frequently wake up with a dry mouth. In women with SS, vaginal dryness may lead to pain during sexual intercourse.
Sjogren's syndrome may affect other organs including the kidneys, gastrointestinal tract, blood vessels, lungs, liver, pancreas, and central nervous system. Once damaged, these organs may generate their own symptoms.