Sjogren’s Syndrome (SS)

Dragon Claw Summary

This nasty little syndrome sometimes shows up as a secondary condition for those with rheumatoid disease or lupus.  It causes dry sore eyes; dry mouth with associated tooth and gum issues and may also impact mucus flow in the nose and anus.

According to the recent guidelines released by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) the key criteria for SS are:

These criteria were developed for use in individuals with signs and/or symptoms suggestive of SS.

  • Anti-SSA/Ro antibody positivity
  • Lymphocytic sialadenitis with a focus score of ≥1 foci/4 mm2, each scoring 3;
  • Abnormal Ocular Staining Score of ≥5 (or van Bijsterveld score of ≥4);
  • Schirmer's test result of ≤5 mm/5 min; and
  • An unstimulated salivary flow rate of ≤0.1 mL/min, each scoring 1.

Typically treatment consists of moisturising drops, mouth gel and drinking water regularly.  More severe cases may require intervention by an eye specialist.

Sources: Annals of Rheumatic Disease 2017;76:9-16 doi:10.1136/annrheumdis-2016-210571; and