Sjögren’s Syndrome

The symptoms of pediatric Sjögren's syndrome are different than those seen in adults. For example, children rarely experience dry eyes and dry mouth—typical symptoms of Sjögren's syndrome in adults.

The most common symptoms of Sjögren's syndrome in children are unexplainable rashes on the skin and general fatigue and malaise (tiredness). Children with Sjögren's syndrome can also have the following symptoms:

• Joint pain, swelling and stiffness
• Swelling in the saliva glands—specifically those behind the jaw and in front of the ears
• Patches of dry skin
• Persistent dry cough

Some children with Sjögren's syndrome have no symptoms at all, and the condition is discovered when the doctor is looking for another condition, such as juvenile idiopathic arthritis.

Sometimes, a newborn can be born with neonatal lupus syndrome, because his or her mother had Sjögren's antibodies in her system during the pregnancy. These antibodies may not produce symptoms in the mother, so she may not be aware that she has characteristics of Sjögren's until the antibodies are passed on to her child. Note that neonatal lupus does not lead to Sjögren's syndrome. Rather, it is the result of Sjögren's syndrome antibodies that the mother unknowingly shares with the baby before birth.

Diagnosis of Sjögren's Syndrome

Your child’s doctor may use one or more of the following tests to diagnose Sjögren's syndrome:

• Blood test. Your child’s doctor may perform a blood test to analyze the levels of various blood cells and look for the presence of Sjögren's antibodies, inflammation or problems with the liver and kidneys.
• Eye test. Your child’s doctor may use a Schirmer tear test to measure the dryness of the eye. This is a simple test in which the doctor uses a small piece of filter paper placed under the lower eyelid to measure tear production. Though children rarely complain of dry eyes associated with this condition, the eye test is a common, noninvasive test the pediatric rheumatologist can run if he or she suspects your child may have this condition.
• X-ray. Special types of X-ray imaging called sialogram (X-ray test that uses contrast dye) and salivary scintigraphy (noninvasive scan of the glands) may be used to check the function of the salivary glands.
• Biopsy. Your child’s doctor may perform a lip biopsy (collection of a small tissue sample) to check for the presence of clusters of inflammatory cells, which can be an indication of Sjögren's syndrome.