Dr. Abhijeet Bhosikar
Connective Tissue Disease

Sjögren's Syndrome — Treatment in Pune

Also known as: Sicca Syndrome

Dry eyes and dry mouth that deserve investigation rather than eye drops alone.

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What is Sjögren's Syndrome?

Sjögren's syndrome is an autoimmune disease in which lymphocytes infiltrate and destroy the moisture-producing glands — chiefly the tear and salivary glands.

It is far more than dryness. Fatigue, joint pain, neuropathy, kidney tubular problems, lung disease and a genuinely increased risk of lymphoma make it a systemic condition requiring long-term surveillance.

It occurs on its own (primary) or alongside rheumatoid arthritis, lupus or scleroderma (secondary), and disproportionately affects middle-aged women.

A glass of water on a pale surfaceIllustrative
Two to three litres of fluid a day helps the kidneys clear urate, unless fluids have been restricted for another reason.

Symptoms of Sjögren's Syndrome

Early signs

  • Gritty, burning eyes as if sand is trapped under the lids
  • Dry mouth needing water to swallow dry food such as chapati or biscuits
  • Rapidly increasing dental cavities and gum disease
  • Dry throat, hoarseness or a persistent dry cough
  • Joint pain and profound fatigue

If left untreated

  • Recurrent parotid or submandibular gland swelling
  • Vaginal dryness and painful intercourse
  • Numbness or burning of hands and feet (small fibre neuropathy)
  • Purpuric rash on the legs, or Raynaud's phenomenon
  • Persistent gland enlargement or lymph node swelling — needs lymphoma evaluation

Causes & risk factors

  • Autoimmune lymphocytic infiltration of exocrine glands
  • Anti-Ro (SSA) and anti-La (SSB) antibody production
  • Genetic HLA associations and female hormonal influence
  • Possible viral triggers in susceptible individuals
  • Association with other autoimmune disease, including thyroid disease

How Sjögren's Syndrome is diagnosed

No single test diagnoses a rheumatic disease. The diagnosis comes from combining the pattern of symptoms, the examination findings, and only the investigations that answer a specific question.

  1. Anti-Ro (SSA) and anti-La (SSB) antibodies

    The key serological markers. Anti-Ro also matters in pregnancy because of the risk of neonatal lupus and congenital heart block.

  2. Schirmer's test and ocular staining

    Objective measurement of tear production and of corneal surface damage, done with ophthalmology input.

  3. Unstimulated salivary flow and gland imaging

    Salivary flow rate, ultrasound of the parotid and submandibular glands, or sialography where needed.

  4. Minor salivary gland biopsy

    A small lip biopsy showing focal lymphocytic sialadenitis — the most definitive test in seronegative but clinically convincing cases.

  5. Systemic screening

    Kidney function and urine pH for renal tubular acidosis, lung imaging, immunoglobulins, complement and cryoglobulins. Low C4 and cryoglobulinaemia are lymphoma risk markers.

Treatment options

Structured dryness management

Preservative-free artificial tears, gels at night, ciclosporin eye drops, and punctal plugs for refractory dryness — coordinated with an ophthalmologist.

Saliva stimulation and oral protection

Pilocarpine or cevimeline, sugar-free gum, frequent sips of water, high-fluoride toothpaste and dental review every six months. Dental preservation is a core part of treatment.

Hydroxychloroquine

For joint pain, fatigue and rash — the standard systemic agent for non-organ-threatening disease.

Immunosuppression for systemic involvement

Steroids, azathioprine, mycophenolate or rituximab where there is neuropathy, lung, kidney or vasculitic disease.

Lymphoma surveillance

Annual review of gland size, lymph nodes, immunoglobulins and complement. Persistent one-sided gland swelling is investigated promptly rather than watched.

Seek urgent medical attention if you have

  • Persistent, firm, one-sided swelling of a salivary gland
  • New enlarged lymph nodes, night sweats or weight loss
  • Sudden vision change or severe eye pain
  • Numbness, weakness or a new purpuric rash
  • Unexplained muscle weakness or paralysis from hypokalaemia (renal tubular acidosis)

Do not wait for a scheduled appointment for any of the above. Call the clinic on +91 70571 19999 or attend the nearest emergency department.

Frequently asked questions about Sjögren's Syndrome

Are dry eyes always Sjögren's?
No — screen use, air conditioning, contact lenses, age and many medications cause dryness far more often. Sjögren's is suspected when dryness is persistent and severe, especially with dry mouth, dental decay, gland swelling, joint pain or fatigue.
Does Sjögren's cause cancer?
It carries a modestly increased risk of non-Hodgkin lymphoma compared with the general population. The absolute risk remains low, and regular surveillance is precisely what allows early detection.
Does it affect pregnancy?
Anti-Ro and anti-La antibodies can cross the placenta and rarely cause congenital heart block. Pregnancies are monitored with fetal echocardiography during the critical weeks, and hydroxychloroquine appears to reduce this risk.

Get an expert opinion on Sjögren's Syndrome in Pune

Consultations at the Ravet clinic in Pimpri-Chinchwad. Bring your previous reports — a properly reviewed history usually saves repeating tests.

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Part of a wider group

Autoimmune & Connective Tissue DiseaseMulti-system disease where the complications that matter are silent early.

Related conditions

  • Lupus (SLE)

    A multi-system autoimmune disease where early kidney screening changes the entire prognosis.

  • Rheumatoid Arthritis

    Symmetric small-joint swelling that responds best when treated within the first 12 weeks.

  • Raynaud's Phenomenon

    Usually harmless — but sometimes the first sign of autoimmune disease years in advance.

  • Scleroderma

    Skin tightening that signals a disease needing yearly heart and lung surveillance.

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