A dry syndrome can evoke an autoimmune disease of the secretion glands (exocrines): Sjögren syndrome. A "dry syndrome" is quite common during lupus. More than a third of lupus patients complain of dry mouth and/or eyes. This dryness is linked to an immune-induced inflammation of the glands that produce saliva (salivary glands) and tears (lacrimal glands). A biopsy of these (salivary) glands can be done to make the diagnosis of dry syndrome. In this case, the biopsy shows an infiltrate of cells (lymphocytes) that invade these glands. This infiltrate is classified according to its intensity (Chisholm and Mason classification). Only a significant lymphocyte infiltrate has diagnostic value.

This dry autoimmune syndrome, called Sjögren's syndrome, can be associated with lupus, but also with other autoimmune diseases, such as rheumatoid arthritis.

Menopause and certain medications (antihistamines for allergy and antidepressants for example) are also likely to cause dryness.

How should this dry syndrome be managed?

The appearance of Sjögren syndrome during lupus does not reflect the activity of the disease. There is no cure for this syndrome and we can therefore only relieve its symptoms, with the use of tears and tear gel, artificial saliva and drugs that stimulate secretions (pilocarpine hydrochloride).

In case of severe dryness, it can be useful to have the opinion of an ophthalmologist to check that there are no ocular complications (dry keratoconjunctivitis).

Ensuring regular dental care is essential, because the absence of saliva reduces the natural defences of the teeth which risk damage.