Talk:Sjögren syndrome

Omega EFA with Vitamin E
This last story about Omega EFA with Vitamin E is complete BSJfmarchini 02:39, 10 November 2006 (UTC)

research
The sentence " HLA-DQ2 and HLA-B8 are generally found in Caucasian patients, while HLA-DR5 is related to Greek and Israeli patients" doesn't make any sense. Greek and Israelis are Caucasian. — Preceding unsigned comment added by 61.223.2.83 (talk) 13:20, 29 November 2013 (UTC)

scleroderma
i think you can get sjogren's symptoms with scleroderma. we probably should add that somewhere. 207.151.234.103 (talk) 23:28, 7 April 2008 (UTC)

Lupus
According to http://www.lupusnsw.org.au/sjogrens.html there is often a connection with Lupus... This should be mentioned Vk2tds (talk) 09:50, 23 October 2008 (UTC)

One of the things that bothers me about this "syndrome" is that it afflicts the specific segment of society that is usually over-medicated or mis-medicated with certain types of drugs which can cause the same side effects as listed as symptoms here. If you have a female over the age of 35 who has been dosed with a statin over a period of time, and who has then had a side effect of pain in the knee or joint areas; you usually see a female who is then given stronger & stronger pain medication to try to alleviate that pain. In that same female you may will also see a need for a diuretic due to regular monthly bloating reasons, at least until the end of menopause & then due to a lack of exercise. A diuretic while being great for reducing liquid in the ankles or joints; can cause dryness in other areas. The pain medications to cover the side effects caused by the statins can also cause dryness of mouth & eyes & has been known to contribute to mouth lesions and other side effects dealing with the gums & teeth. Consider the fact that if you take a number of female patients over the course of say, 50 years between the ages of 35 & 85; many of them will have been, at one time or another on either pain medication, cholesterol medication and/or diuretics & there is a possibility that they may have been on all three or more at the same time. Instead of attempting to call this yet another problem; why not attempt to reduce or change the types of medication that they are on to see if there is a reduction in the symptoms. Even the "symptom" of reduced urine output can be directly attributed to diuretic use. Many females in this particular age grouping do not drink enough water to start with. Given the fact that many women will not drink enough liquid, are on a combination of medications that can reduce urine & liquid output; you can't rule out the fact that this may not be a "condition" at all. This could be a combined side effect that needs to have an exchange, reduction or removal of medications instead of using even more medications on top the ones already given to try to again mask the reactions.ladygrey21```` —Preceding unsigned comment added by Ladygrey21 (talk • contribs) 02:26, 12 August 2009 (UTC)

While you may be skeptical as you refer to this as a "syndrome" and clearly are trying to debunk this "myth" in your post, you fail to realize that while it can be associated with a disease like Lupus, it isn't always. So your suspicion that it is a result of drug side effects shows only how little you know about the disease. My mother is a diagnosed sufferer and has never had Lupus nor does she take pain meds or statin drugs. She was given Prednesone one time and immediately threw her into severe Sjogrens symptoms (evidence of it being mildy present was ignored as mild symptoms can be dismissed as everyday issues like dry eyes etc.). This is the only drug related issue for her. She now lives, trapped in her home, with cold air humidifiers keeping the humidity at 80% at all times and uses preservative free eye drops, nasal ointments and pillocarpine for saliva. She has had food be caught in her esophagus requiring emergency surgery to remove. Which due to her condition creates all new problems as Doctors want to ignore her condition and try to not use humidified Oxygen during surgery. While in the ER the nurse ignored her and tried to jam a tube down her nose while she was screaming. They eventually realized she was being honest and couldn't get the tube down cause she had no mucus. Doctors are rarely informed as to this illness. So while it's bad enough having doctors tell her she needs to go to the Cleveland Clinic because she doesn't have Sjogrens Syndrome, when they were the ones who told her she had it, so let's not start the false idea that it's not a "syndrome" but Lupus sufferers with menopause on too many drugs who don't drink enough water, OK? I'm slowly watching my mother die from what you consider to be a simple case of over medication. What life she has left is devoid of any real value or pleasure and her future is bleak and sadly, it appears death is her only release. While I know her condition is the extreme form and not the typical symptoms you commonly read about ( They usually only speak of the minor issues of this disease, not the part where it can dry your organs and cause a slow painful death while robbing you of life up until then)I hope you take the time to research further diseases and people who have them in real life before you make your suppositions in the future. — Preceding unsigned comment added by 184.56.29.252 (talk) 16:01, 22 July 2011 (UTC)


 * what you both fail to realize is that this is a wikipedia talk page. it is for discussion of the article, not discussion of the article's topic.there are,i'm sure, numerous discussion sites for both sjogren's and lupus, and all related issues. this is not the place.Toyokuni3 (talk) 18:41, 24 July 2011 (UTC)

Recent review
A recent review on this topic was published in JAMA  Doc James  (talk · contribs · email) 11:11, 21 August 2010 (UTC)
 * A free article, I would add. In a nutshell:
 * Conclusions In primary Sjögren syndrome, evidence from controlled trials suggests benefits for pilocarpine and cevimeline for sicca features and topical cyclosporine for moderate or severe dry eye. Anti–tumor necrosis factor agents have not shown clinical efficacy, and larger controlled trials are needed to establish the efficacy of rituximab.
 * --Nbauman (talk) 18:30, 12 December 2012 (UTC)

Mikulicz disease
Mikulicz disease(MD) should not link to the Sjogren page. MD is a constellation of clinical findings (bilateral painless swelling of lacrimal, submandibular, parotid glands for greater than 3 months), thought to be a consequence of IgG4-related sclerosing disease. Sjogren's may occasionally result in something like MD but the terms are not synonymous. Pwawryko (talk) 15:56, 15 September 2010 (UTC)

Venus Williams
An edit earlier today added Venus Williams to the see also section, noting that she has recently been diagnosed with the syndrome. I removed this link as it appears trivial and out of place. I doubt it is common policy to reference celebrities with diagnosed conditions outside their own article. I just wanted to have a record of why I made this edit. IrishStephen (talk) 01:27, 1 September 2011 (UTC)

An anonymous editor stuck "What does this have to do with the disease?" after the reference to VWilliams. ClueBot reverted the change -- good -- but what does it have to do with the disease? Crohn's disease has a 'Notable cases' section; Huntington's disease mentions Woody Guthrie only in the context of support organizations. I propose moving the VWilliams text to a new 'Notable cases' section. -- Jo3sampl (talk) 21:15, 1 March 2012 (UTC)


 * I'm not a *strong* proponent of having it in the article, but it is notable, and it would give a good "visual aid" or real-life example of the condition that people may be familiar with, which could be a good thing. I guess my vote would be in favor of mentioning it, not that we are voting... but only if it can be done in a way that is not awkward and doesn't decrease the readbility of the article. Dr.queso (talk) 22:08, 30 May 2012 (UTC)

maybe not a see also, but other articles include people of note who suffer from a respective disease/condition.

I foresee this page getting quite a few hits now that VW has gone public -- that's how I got here ;) VulpineLady (not signed in) 71.51.190.225 (talk) 22:50, 1 September 2011 (UTC)

SS excluded from people with past Hep C?
"SS can be excluded from people with past head and neck radiation therapy, hepatitis C infection, Acquired immunodeficiency syndrome (AIDS), pre-existing lymphoma, sarcoidosis, graft-versus-host disease, and use of anticholinergic drugs (since a time shorter than four times the life of the drug)."

What is the basis for this statement? Is there a medical reference that can support this statement?

204.116.190.169 (talk) 13:04, 31 December 2011 (UTC)Cathy


 * I suspect that it refers to present HepC, that is,
 * past radiation,
 * Hep C,
 * AIDS, etc.
 * Have you tried looking for a good source? WhatamIdoing (talk) 22:39, 3 January 2012 (UTC)

SS excluded from people with sarcoidsis?
I have both and I have looked online and seen other people with both. I don't believe this statement is true. — Preceding unsigned comment added by 50.47.115.59 (talk) 00:22, 29 April 2012 (UTC)

Diagnosis
The current text reads: "Typical Sjögren's syndrome ANA patterns are SSA/Ro and SSB/La, of which SSB/La is far more specific; SSA/Ro is associated with numerous other autoimmune conditions, but are often present in Sjögren's. However, SSA and SSB tests are frequently not positive in Sjogren's syndrome."

While factually true, the last line is grossly misleading. The informational content of the last sentence can be substantially improved to be genuinely useful and correct for readers, as follows.

Patients who are seronegative for SSA and SSB antibodies require a mandatory positive lip biopsy result to receive a diagnosis of Sjogren's. One definitive reference for the this comes from Dr. Alan N. Bauer, (2012, The Sjogren's Book, Sjogren's Syndrome Foundation,  Wallace, Daniel J. editor;  Table 18-1 Diagnostic Testing in Sjogren's, pg. 174.  This Sjogren's Foundation-published reference is definitive enough, however, numerous additionally valid and equally specific references are readily available for this common diagnostic, non research, criteria for the routine diagnosis of Sjogren's and are easily found.

The last line of the cited text (above) is grossly misleading, indicating simply that patients frequently test negative for SSA and SSB antibodies and are still diagnosed with Sjogren's.

One (obvious) problem is this: without a positive SSA test, or a positive SSB, or else a positive lip biopsy, then patients simply have nonspecific symptoms of dry eye and/or dry mouth, and/or other nonspecific symptoms. There has to be some specific diagnostic indicator for Sjogren's: if nonspecific symptoms are the sole diagnositc criteria, then there are no criteria for diagnosis of Sjogren's, anyone who claims to have nonspecific symptoms or "seronegativity" can then have it, and the diagnosis then means nothing. As the text is currently written, many people who are seronegative for SSA and SSB antibodies have no guidance in what commonly constitutes a valid diagnosis of "serognegative" Sjogren's, and may therefore spend additional years lost in the despair of remaining undiagnosed before discovering that they need for the lip biopsy to establish a seronegative diagnosis.

As is stated in the mandatory criteria for diagnosis of Sjogren's Syndrome by Dr. Baer, a patient must have either positive SSA antibodies, positive SSB antibodies, or in the absence of these, a positive lip biopsy to receive a valid diagnosis of Sjogren's Syndrome. The last line of the cited text needs to be revised to provide this important and relevant fact. — Preceding unsigned comment added by 208.123.190.37 (talk) 05:16, 4 December 2014 (UTC)

Lymphomas in people with Sjögren's
10.1111/bjh.13192 - BJH review JFW &#124; T@lk  09:21, 22 January 2015 (UTC)

Epidemiology
I think there's an error in the Epidemiology section of the page. The wikipedia page says that Sjogren's is the third most common autoimmune disease, with SLE being more common than Sjogren's. However, the citation linked to that statement actually specifies Sjogren's as being the second most common autoimmune disease. The SLE page on Wikipedia lists the global prevalence of SLE at approximately 20-70/100,000 people (0.02-0.07%). The Sjogren's page estimates the prevalence of Sjogren's at up to 3% of the population, which makes it several orders of magnitude more common than SLE if the SLE prevalence information is correct. I think the start of this section should say (based on the references given and the prevalence information given) that "Sjogren’s syndrome is the second most common rheumatic autoimmune disorder, behind only rheumatoid arthritis (RA)." i.e. Without the reference to SLE as well. However being a medical page, I didn't want to make the edit without someone more knowledgeable in the field reviewing the changes first. 58.96.87.33 (talk) 13:48, 3 March 2015 (UTC)


 * @58.96.87.33 Should the statement just be deleted? The full statement as it currently exists is inconsistent ("Sjögren's syndrome (SS) is the second-most common rheumatic autoimmune disorder, behind rheumatoid arthritis and systemic lupus erythematosus"), the freely accessible portion of the citation doesn't clarify (it says SS is second, but not what's first), and I'm unable to find such a ranking or comparison elsewhere (some time in particular spent digging through free articles on PubMed). The cited article is also from 2000—not very current. Half-delighted (talk) 05:27, 18 September 2023 (UTC)

Under the influence
>Though the cause of Sjögren’s syndrome is unknown, it is believed to be under the influence of a combination of genetic, environmental, and several other factors,

Is there a better phrase for "...believed to be under the influence of...."? "It is controlled by a combination of genetic etc"? "Influenced by a combination of genetic etc"? Thank you. Rissa, Guild of Copy Editors (talk) 03:39, 1 April 2015 (UTC)

gum (preferably sugar free)
Why should the gum for mouth dryness be "preferably sugar free"?--Richardson mcphillips (talk) 20:46, 10 November 2017 (UTC)
 * Sugar free gum is to lessen the possibility of tooth decay, since Sjogren's patients often have dental decay issues due to reduced saliva flow. Also, since Sjogren's patients often have gastrointestinal disturbance issues, especially achlorhydria, sugar free gum will be less likely to upset the stomach. JGKlein 21:39, 10 November 2017 (UTC)
 * The only answer that is relevant here, is "because that is what the source says". This is not the reference desk. Jytdog (talk) 16:35, 11 November 2017 (UTC)

Move request
This page was just moved but am not seeing a discussion. The ICD10 uses a version without the 's so moving back. Doc James  (talk · contribs · email) 14:02, 27 June 2018 (UTC)
 * That was arrogant of me. So you moved it back without investigating the reasons I gave or starting that discussion? Payback in-kind? "The page was originally moved based on a Requested moves." No, it was on Requested moves/Technical requests, implying that the requester would have done it themselves but could not and, as always, there was no "discussion" whatsoever – so much for unvetted "formal move requests". The reason given was "to match the article text" (but the article text was and still is mixed with multiple variations, copied incorrectly from article names and even the Foundation's name). Anthony Appleyard made this "uncontroversial technical request" with no sign of thinking about it. I contest that "uncontroversial" undiscussed move. I'm too late, as always, huh? I undid the move because it was wrong. You put it back because I am wrong. Where did you get your consent? Can you say who made the WHO and ICD10/ICD11 the ultimate and only arbiter of correctness in Wikipedia, overriding Mayo Clinic, the Foundation, NHS, and prevalence (almost everyone else)? Everywhere in English it is Sjögren's syndrome (also the original Swedish, minus the apostrophe - don't they have a say?). Only a small minority of articles get it "right" as you see it. Is there a mission to impose a WHO committee's idea of correctness on the world? Maybe we must rename every chemical to the international name (dodecan or dodecane?). Yes I've noticed the fad of dropping the 's from some disease names (Hodgkin, Down, Huntington?). No one needs it. It's confusing. Is it official? (Cite.) Rephrasing: A human moved the page, it didn't "was moved". You did not see a discussion. So indeed.
 * "Originally moved" – now there's a new oxymoron to remember. - A876 (talk) 22:14, 27 June 2018 (UTC)
 * Fortunately, we have a Manual of Style, so we don't have to debate this. Please see WP:NCMED. Natureium (talk) 23:07, 27 June 2018 (UTC)
 * I see. Thank you, Natureium, I stand corrected. Doc James's edit summary was "Doc James moved page Sjögren's syndrome to Sjögren syndrome over redirect: moving back per ICD10". He did not say "per ICD10 per WP:NCMED" – and I failed to find it for myself. Indeed, Wikipedia (in my words) "made the WHO and ICD10/ICD11 the ultimate and only arbiter of correctness in Wikipedia, overriding Mayo Clinic, the Foundation, NHS, and prevalence (almost everyone else)" (e.g. the Swedes and probably Sjögren himself).
 * Obviously I don't like these renamings. I surely won't be the first to apply them anywhere.
 * WHO seems to have dictated these renamings, tacitly as far as I know; perhaps casually; perhaps arrogantly. (Was it decided upon, or did one rogue clerk up-and do it?) Can anyone tell me where WHO even admits to authoritatively renaming [dunno how many] diseases, or even begins to explain why? ...and why they retain this one despite decades of international rejection? ...and why I should instead be happy about the changes? (I'm getting out of scope here. This might be a controversy; I heard the great renaming mentioned decades ago, but I couldn't find a trace of it recently. I doubt it'll be noteworthy. I know, take this up with WHO. I'm sure they'll listen (irony).) - A876 (talk) 18:30, 19 May 2019 (UTC)

Topical ocular androgen
why don't we use estrogen with females? Higher incidence in females seems to be due to the frequent loss of estrogen. This is the section where the author mentioned androgen treatment suggestion: "It has been hypothesized that androgen administration to the ocular surface may serve as an effective therapy for dry eyes." — Preceding unsigned comment added by Yasir muhammed ali (talk • contribs) 10:10, 27 July 2018 (UTC)

article should refer to fatigue
e.g. https://www.smartpatients.com/conversations/fatigue-surprisingly-little#top — Preceding unsigned comment added by 5.66.63.86 (talk) 02:52, 1 May 2023 (UTC)
 * This is not WP:MEDRS quality, it's not an WP:RS by any means. — Shibboleth ink  (♔ ♕) 16:42, 6 May 2023 (UTC)

Come again?
Is there an English translation for this bit, as seen under Diagnosis: Blood tests ? "Typical SS ANA patterns are SSA/Ro and SSB/La, of which anti-SSB/La is far more specific; anti-SSA/Ro is associated with numerous other autoimmune conditions, but is often present in SS, but aAnti-SSA and anti-SSB tests are frequently not positive in SS.[citation needed]" Let's give the common reader a break! Thank you for your attention, Wordreader (talk) 17:45, 26 October 2023 (UTC)


 * Hi, @Wordreader. AFAICT that string of jargon means:
 * "A blood test may identify a particular set of antibodies in people with Sjögren's. Two of them, called SSA/Ro and SSB/La, are common in Sjögren's.  The first turns up in a lot of autoimmune diseases (including this one), but the second is usually seen only in Sjögren's.  It's also important to note what's not found:  a different pair of antibodies, called anti-SSA and anti-SSB, are not usually found in people with Sjögren's."
 * If you feel like you understand the content better, please feel free to re-write the article in plain English. WhatamIdoing (talk) 00:30, 29 October 2023 (UTC)

Article name needs to change surely?
Everyone calls this Sjogren's - with an s on the end? Asto77 (talk) 17:56, 28 October 2023 (UTC)


 * Hello, @Asto77.
 * WP:NCMED says that when in doubt, editors should normally follow the WHO's ICD system, which does not use the possessive apostrophe in this case. I believe that the preference is regional, e.g., Americans usually add an apostrophe and Brits usually don't. WhatamIdoing (talk) 00:25, 29 October 2023 (UTC)
 * tks.
 * Your ref says "The article title should be the scientific or recognised medical name". it's actually hard to find any reputable source calling it Sjögren (e.g. https://www.stanfordchildrens.org/es/topic/default?id=sjgren-syndrome-134-120).
 * I think the current name of the article sounds like its non-credible, and so
 * a) immediately puts readers off, and
 * b) damages wiki.
 * (WHO are behind the curve.) Asto77 (talk) 07:50, 29 October 2023 (UTC)
 * NCMED says:
 * Where there are lexical differences between the varieties of English, an international standard may be helpful, though Wikipedia generally discourages changing existing article usage. Some terminology is in flux and recently proposed names may not yet be widespread in adoption. Some examples of international standards include:
 * Diseases—The World Health Organization, International Statistical Classification of Diseases and Related Health Problems (ICD-10)...
 * A children's hospital in California is not "an international standard". WhatamIdoing (talk) 20:33, 29 October 2023 (UTC)
 * Come on.
 * "Sjogren's"
 * All academic researchers
 * NIH
 * NHS
 * NICE
 * American College Rheumatology
 * Mayo
 * Cleveland Clinic
 * John Hopkins
 * Cedars-Sinai
 * American Dental Association
 * DermNet NZ
 * Deutsches Ärzteblatt International
 * Oxford Academic
 * Elsevier
 * Walters Kluwer
 * JAMA
 * European Respiratory Review
 * The Lancet
 * Sjogren's Foundation
 * Arthritis Foundation
 * Versus Arthritis
 * British Sjogren's Syndrome Association
 * https://sjogrenliitto.fi/sjogrenin-syndrooma/
 * etc
 * "Sjogren"
 * WHO
 * Stanford Children's
 * Sjogren Europe
 * https://www.afgs-syndromes-secs.org/
 * it's not even close.
 * The downside is wiki now appears way down the page on a search for Sjogren's; do we really want that? Asto77 (talk) 10:33, 31 October 2023 (UTC)
 * @Asto77 - I don't think it's a contest. Wordreader (talk) 20:16, 14 November 2023 (UTC)
 * @Asto77 - I just found the "Sjögren's Foundation" website, if you are interested in how they spell their name - https://sjogrens.org
 * Yours, Wordreader (talk) 02:40, 15 November 2023 (UTC)
 * @Asto77 - Ooops! NOW I see where you already found the Foundation's spelling. (It's still not a contest, though.) Yours, Wordreader (talk) 03:56, 15 November 2023 (UTC)
 * it's not even close.
 * The downside is wiki now appears way down the page on a search for Sjogren's; do we really want that? Asto77 (talk) 10:33, 31 October 2023 (UTC)
 * @Asto77 - I don't think it's a contest. Wordreader (talk) 20:16, 14 November 2023 (UTC)
 * @Asto77 - I just found the "Sjögren's Foundation" website, if you are interested in how they spell their name - https://sjogrens.org
 * Yours, Wordreader (talk) 02:40, 15 November 2023 (UTC)
 * @Asto77 - Ooops! NOW I see where you already found the Foundation's spelling. (It's still not a contest, though.) Yours, Wordreader (talk) 03:56, 15 November 2023 (UTC)
 * Yours, Wordreader (talk) 02:40, 15 November 2023 (UTC)
 * @Asto77 - Ooops! NOW I see where you already found the Foundation's spelling. (It's still not a contest, though.) Yours, Wordreader (talk) 03:56, 15 November 2023 (UTC)

Variation in severity?
Greetings,

My Nurse Practioner thinks that I may have Sjögren's Syndrome as I seem to have some symptoms. But after reading about the condition on the 'net, it can be horrifying. I am certainly not sick like the descriptions suggest; I do not feel sick at all.

So, is there a range of severity for this condition - from mild to very severe? The NP gave me an appointment for a rheumatologist, but I hate to waste everyone's time if the condition always manifests as severe and I am sans-SS.

I am NOT asking for medical advice or a diagnosis, only if there is variation in the level of severity. Thank you for your time, Wordreader (talk) 18:56, 14 November 2023 (UTC)


 * Make that "if there is significant variation in the level of severity". Thanks again, Wordreader (talk) 20:15, 14 November 2023 (UTC)
 * @Wordreader, I believe that, at least in the earlier years, the symptoms are often so mild that the diagnosis is missed entirely. I don't know if it always becomes severe (I doubt it; variability is typical of autoimmune diseases), but I can tell you that the people who hang out on medical internet forums aren't representative.  It's a bit like everyone else at the gym looking better than you – not because you're worse than average, but because the people you see the most of are the ones who spend all day, every day working out, and the ones you see the least of are the ones who zipped in, did the minimum, and rushed back out. WhatamIdoing (talk) 21:10, 14 November 2023 (UTC)
 * @WhatamIdoing - Thank you so much for your reply. I guess I better keep the rheumatology appointment, then. Bleeech! >_< Wordreader (talk) 21:23, 14 November 2023 (UTC)

Sjogrens
I believe the experts have changed Sjogrens from a syndrome to a disease. 73.44.92.20 (talk) 12:34, 1 May 2024 (UTC)