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August 2010, Volume 40 Number 8 , p 36 - 41


  • Richard L. Pullen EdD, RN
  • Deborah A. Hall MSN, RN


SJÖGREN SYNDROME (SS), which is pronounced SHOW-grin or SHOW-gren, is one of the most common rheumatologic disorders after rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE).1,2 SS is a chronic, slowly progressive autoimmune disease that affects the exocrine glands, most commonly the lacrimal and salivary glands. SS can occur alone (primary SS) or it can occur along with other connective tissue diseases, such as SLE (secondary SS).3 This article describes this autoimmune disease, which can lead to malignant lymphoma and other serious problems, and the nursing care you can provide.SS affects up to 3.1 million people in the United States according to the American College of Rheumatology (ACR).4 It can develop at any age, but most patients are in their late 40s when they're diagnosed, and women are nine times more likely than men to develop SS.5 SS and SLE affect the same population, suggesting that the etiology of the two diseases may be similar.1,6Autoimmune disorders are caused by a breakdown in the immune system's ability to differentiate between self and nonself antigens. In other words, an immune response can be inappropriately mounted against host tissue or antigens, resulting in local or systemic injuries.7SS is characterized by exocrine gland T lymphocyte infiltration, as well as B lymphocyte hyperactivity.3 As lymphocytes infiltrate and attack the exocrine glands, they cause an inflammatory response, which subsequently impairs the glands' ability to function and produce tears or saliva, and eventually destroys them.What activates immune cells in the involved tissues isn't known, but researchers suspect a combination of environmental and genetic factors. Possible triggers include viral or bacterial infections.8SS can also damage major body organs and organ systems, such as the lungs, resulting in pneumonia and interstitial lung disease; liver, resulting in autoimmune hepatitis or primary biliary cirrhosis; and gastrointestinal

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