Sicca Syndrome: Contributing Factors, Symptoms, and Treatments

What is sicca syndrome?

So what is sicca syndrome? Derived from the Latin word sicca, meaning “dry,” it’s a condition that directly affects your immune system. It can potentially impact the quality of your daily life, and its treatment focuses on symptom relief. 

Sjogren’s syndrome can take its toll on any bodily organ which produces moisture, including your throat, nasal passages, skin, sinuses, and vagina. It’s further marked by the overproduction of antibodies that actively destroy your own tissues. Diagnosis of Sjogren’s syndrome sometimes involves a biopsy of the affected gland. 

Note that sicca syndrome tends to accompany other autoimmune disorders, such as lupus or rheumatoid arthritis. The mucous membranes and moisture-producing glands in your eyes and mouth take the brunt of its initial impact, leading to decreased saliva and tear production.

Although sicca can develop at any age, it typically strikes after the age of 40. Women are particularly prone to sicca syndrome. It’s estimated that one percent of the U.S. population (approximately four million people ‒ most of whom are adult females) is battling Sjogren’s syndrome.

History of Sjogren’s syndrome

Named after the Swedish ophthalmologist who discovered it, Sjogren’s syndrome was first reported in a middle-aged female patient displaying sicca symptoms. Nineteen more cases followed, and Henrik Samuel Conrad Sjogren later wrote a doctoral thesis on the subject in 1933.  

Sicca syndrome symptoms

Doctors generally rely on the presence of sicca syndrome symptoms to diagnose the autoimmune disorder. They include:

• Dry eyes that burn, itch, or feel gritty (as if there’s sand in them) 
• Dry mouth which feels like it’s full of cotton, making it difficult to speak, chew, or swallow

In certain instances, sicca syndrome also produces the following warning signs:

• Joint stiffness, pain, and swelling
• Swollen salivary glands (specifically, those located in front of your ears and behind your jaw)
• Dry skin
• Skin rashes (especially after sun exposure)
• Persistent dry cough
• Vaginal dryness
• Chronic fatigue 
• Sore or cracked tongue
• Dry nose
• Peeling or dry lips
• Dry or burning throat
• Increased dental decay
• Digestive issues
• Changes in taste or smell
• Yeast infections 
• Vision problems (e.g., light sensitivity, blurred vision, corneal damage)
• Nerve damage (e.g., tingling and burning in your hands and feet)

Who can develop sicca syndrome?

Sicca syndrome usually occurs in individuals with one or more of the contributing factors below:

• Gender

Generally speaking, women already have an increased likelihood for autoimmune diseases, as they represent approximately 75 percent of all cases. Plus, nine out of every 10 Sjogren’s syndrome patients are women. 

• Age

More often than not, diagnosis of sicca syndrome happens after the age of 40. 

• Rheumatic disease

Many patients with some variation of rheumatic diseases, such as lupus or rheumatoid arthritis, also experience Sjogren’s syndrome. 

Sicca syndrome vs. Sjogren’s syndrome

Sometimes, doctors will try to differentiate between sicca syndrome and Sjogren’s syndrome. Technically, the former causes constant dryness in any part of your body, in the absence of autoimmune problems. 

Sjogren’s syndrome, on the other hand, is an autoimmune disorder that demonstrates additional symptoms besides dryness. Furthermore, it’s challenging to diagnose as symptoms vary greatly from one patient to the next. Lastly, side effects of some medications may mimic signs of Sjogren’s syndrome. 

Your doctor will likely conduct several tests to rule out other diseases before confirming that it’s Sjogren’s syndrome. They include: 

Blood tests

Diagnostic blood tests check for:

• Presence of antibodies common in Sjogren’s syndrome
• Levels of certain types of blood cells
• Evidence of inflammatory issues
• Evidence of liver or kidney dysfunction

Eye tests

A Schirmer tear test is used to measure the dryness of your eyes. A small piece of filter paper is placed under your lower eyelid to gauge tear production.

An ophthalmologist specializing in eye disorders utilizes a magnifying device (known as a slit lamp) to examine the surface of your eyes. They then dispense drops into your eyes to better evaluate any damage to your corneas. 

Imaging tests

A sialogram can detect how much saliva flows into your mouth. Dye is injected into the salivary glands located in front of your ears, which is then picked up by an X-ray.  

Alternatively, salivary scintigraphy is a type of nuclear medicine test with a similar goal. In this case, a radioactive isotope is injected into your vein. The isotope is tracked over the course of an hour to see how quickly it arrives at your salivary glands. 

Biopsies

When Sjogren’s syndrome is suspected, a biopsy may be performed. A small sliver of tissue from the salivary glands in your lip is collected. It’s subsequently examined under a microscope for the presence of inflammatory cell clusters. 

Diagnosis of sicca syndrome

According to the Sjogren’s Syndrome Foundation, it takes an average of three years to diagnose this condition. Unfortunately, many medical experts overlook it due to overlap between sicca syndrome symptoms and those associated with allergies, menopause, chronic fatigue syndrome, lupus, or rheumatoid arthritis.

Causes of Sjogren’s syndrome

Since Sjogren’s syndrome is an autoimmune disorder, it fools your immune system into attacking its tissues and cells. However, scientists remain unclear about exactly what causes Sjogren’s syndrome. 

For some, genetics might play a role, but research shows it must also be triggered by another mechanism. For example, a person with a genetic predisposition toward Sjogren’s syndrome could be triggered by infection with a particular virus or strain of bacteria.

Although it clearly targets the glands that produce tears and saliva, it may spread to other parts of the body. Your joints, thyroid, lungs, liver, skin, nerves, and kidneys are all susceptible to damage from Sjogren’s syndrome. 

Complications of Sjogren’s syndrome

Sjogren’s syndrome has the potential to create other medical issues, such as:

• Eye damage
• Lung infections and scarring, or bronchiectasis
• Pregnancy complications, like a rash or serious infant heart problems
• Increased chance of developing non-Hodgkin’s lymphoma
• Hypothyroidism 

When to see a doctor for sicca syndrome

If you observe any of the above symptoms associated with Sjogren’s syndrome, consult your physician. Even if it’s not sicca syndrome, there could be another underlying issue that requires attention. After a confirmed diagnosis, sicca syndrome treatment is essential to maintaining your overall quality of life. 

Takeaway

Sjogren’s syndrome is a fairly prevalent autoimmune disease that most frequently presents itself in women over 40. It’s tricky to diagnose as it shares several warning signs with other medical conditions. Once diagnosed, however, there are plenty of effective treatment options for alleviating sicca syndrome symptoms, allowing you to live a more comfortable life.