- Achlorhydria
Gastric acid deficiency.
- Acini
One of the small sac-like dilations composing a compound gland.
- ACR (American College of Rheumatology)
A professional association of United States rheumatologists. Criteria (definitions) of many rheumatic diseases are called the ACR Criteria.
- Acupuncture
The procedure of inserting and manipulating needles into various points on the body to relieve pain or for therapeutic purposes.
- Adaptive Immunity
Normally is functionally triggered after activation of the innate immunity system by foreign pathogens.
- Adenopathy
A swelling of the lymph nodes. In Sjögren's, this usually occurs in the neck and jaw region.
- Albumin
A protein that circulates in the blood and carries materials to cells. Decreased in chronic disease.
- Allodynia
Pain due to a stimulus which does not normally produce pain.
- Alopecia
Hair loss.
- Alveoli
Small air sacs in the bronchi of the lungs.
- Amylase
An enzyme present in saliva; another form of amylase is produced by the pancreas.
- Analgesic
A drug that alleviates pain.
- Androgen
A steroid hormone produced from cholesterol in the adrenal cortex, which is the primary precursor of natural estrogens.
- Anemia
Low numbers of red blood cells.
- Angular Cheilitis
Sores at the corners of the mouth (angles of the lips).
- Anhedonia
Loss of interest or pleasure in doing things.
- Anosmia
Loss of smell.
- Anti-Cholinergic
A class of medications that inhibit parasympathetic nerve impulses by selectively blocking the binding of the neurotransmitter acetylcholine to its receptor in nerve cells. A variety of these medications have side effects with resulting dry eyes and dry mouth.
- Anti-DNA (anti-double-stranded DNA)
Antibodies to DNA; seen in half of patients with Lupus.
- Anti-ENA (extractable nuclear antibodies)
A group of antibodies that includes anti-Sm and anti-RNP.
- Anti-Muscarinic Receptor Antibody
This antibody is thought to block the action of the nerves that go to the salivary and lacrimal glands, thereby reducing the production of saliva and tears.
- Anti-RNP
Antibody to ribonucleoprotein. Seen in lupus and mixed connective tissue disease.
- Anti-Sm
Anti-Smith antibody; found only in lupus.
- Anti-SSA (Ro antibody)
Associated with Sjögren’s, sun sensitivity, neonatal lupus, and congenital heart block.
- Anti-SSB (La antibody)
Almost always seen with anti-SSA.
- Antibody
Substance in the blood that is normally made in response to infection. Also referred to as immunoglobulins such as IgG, IgM, etc.
- Anticardiolipin Antibody
An antiphospholipid antibody.
- Anticentromere Antibody
Antibodies to a cell nucleus associated with scleroderma.
- Antigen(s)
A chemical substance that provokes the production of antibody. In tetanus vaccination, for example, tetanus is the antigen injected to produce antibodies and hence protective immunity to tetanus.
- Antimalarial Drugs
Quinine derived drugs, which were first developed to treat malaria and can manage Sjögren's such as hydroxychloroquine (Plaquenil).
- Antimitochondrial Antibodies (AMA)
Antibodies (immunoglobulins) formed against mitochondria, primarily mitochondria in cells of the liver found in Sjögren's patients with biliary cirrhosis.
- Antinuclear Antibodies (ANA)
Autoantibodies directed against components in the nucleus of the cell. Screening test for lupus and other connective tissue diseases including Sjögren's.
- Antiphospholipid Antibody
Antibodies to a constituent of cell membranes seen in one-third of those with SLE. In the presence of a cofactor, these antibodies can alter clotting and lead to strokes, blood clots, miscarriages, and low platelet counts. Also detected as the lupus anticoagulant.
- Antiphospholipid Antibody
Antibodies to a constituent of cell membranes seen in one-third of those with SLE. In the presence of a cofactor, these antibodies can alter clotting and lead to strokes, blood clots, miscarriages, and low platelet counts. Also detected as the lupus anticoagulant.
- Antiphospholipid Antibody Syndrome (APS)
Thromboembolic events in a patient with antiphospholipid antibody.
- Antispasmodic Drugs
Medications that quiet spasms. Usually used in reference to the gastrointestinal tract.
- Apoptosis
Programmed cell death.
- Aqueous Deficient Dry Eye
Disruption of the tear film either because of inadequate secretion of tears arteries become swollen and damaged.
- Arachadonic Acid
An unsaturated fatty acid found in animal fats that is essential in human nutrition and is a precursor in the biosynthesis of some prostaglandins.
- Arteriole
A very small artery.
- Arthralgia
Pain in a joint.
- Arthritis
Inflammation of a join.
- Ascites
An abnormal fluid that collects in the abdomen due to certain liver and other disorders.
- Atelectasis
A collapse of lung tissue affecting part or all of one lung.
- Atrophic Rhinitis
Autoimmune destruction of acid producing parietal cells of the stomach. May lead to vitamin B12 deficiency and pernicious anemia. Up to 20% of SS patients may have antibodies against parietal cells.
- Atrophic Vaginitis
A condition characterized by dryness and inflammation of the vagina with thinning of the epithelial lining due to estrogen deficiency.
- Atrophy
A thinning of the surface; a form of wasting.
- Atrophy
A thinning of the surface; a form of wasting.
- Autoantibody
Antibody that attacks the body's own tissues and organs as if they were foreign.
- Autoimmune Hepatitis
Inflammation of the liver that occurs when immune cells mistake the liver's normal cells for harmful invaders and attack them.
- Autoimmune Pancreatitis
An increasingly recognized type of chronic pancreatitis that can be difficult to distinguish from pancreatic carcinoma but which responds to treatment with corticosteroids, particularly prednisone. Rare complication of Sjögren's.
- Autoimmune Thyroiditis
Disease of the thyroid gland due to autoimmunity in which the patient's immune system attacks and damages their thyroid.
- Autoimmunity
A state in which the body inappropriately produces antibody against its own tissues. The antigens are components of the body.
- Autonomic Neuropathy
Nerve damage that affects the autonomic nervous system, which controls digestive, bladder, bowel, cardiac, and sexual function.
- B Cell or B lymphocyte
A white blood cell that makes antibodies.
- B Cell or B Lymphocyte
A white blood cell that makes antibodies.
- BAFF (B cell Activating Factor of the TNF Family), also called BLyS
A powerful driver of B cell development.
- Basal (Resting) Rate
Unstimulated (used in reference to both tears and salivary flow).
- Biologic Therapies
Treatment to stimulate or restore the ability of the immune (defense) system to fight infection and disease.
- Blepharitis
Common, persistent and sometimes chronic inflammation of the eyelids, resulting from bacteria that reside on the skin.
- Bolus
A morsel of food, already chewed, ready to be swallowed.
- Brain fog
Impaired concentration and memory that can be due to various causes.
- Bronchi
Branches of the trachea.
- Buffer
A mixture of acid or base that, when added to a solution, enables the solution to resist changes in the pH that would otherwise occur when acid or alkali is added to it.
- C-Reactive Protein (CRP)
The test measures systemic inflammation. Produced by the liver. The level of CRP rises when there is inflammation throughout the body.
- Calcification
A process in which tissue or noncellular material in the body becomes hardened as the result of deposits of insoluble calcium salts.
- Candida
A yeast-like fungal organism.
- Candidiasis
A condition affecting the skin or oral mucosa caused by overgrowth of the common yeast (fungus) Candida. Formerly called moniliasis.
- Cariostatic
Having the ability to help prevent dental caries.
- Cartilage
Tissue material covering bone. The nose, outer ears, and trachea consist primarily of cartilage.
- Celiac Disease
Gluten intolerance.
- Celiac Spruce
An inherited, autoimmune disease in which the lining of the small intestine is damaged from eating gluten and other proteins found in wheat, barley, rye, and possibly oats. Also known as gluten enteropathy. May be 10 times more prevalent in Sjögren's patients than in general population.
- Central Nervous System
The brain and spinal cord.
- Cheilitis
Sores at the corners of the mouth (angles of the lips).
- Chronic Active Hepatitis
A disorder that occurs when viral hepatitis proceeds in an active state beyond its usual cause.
- Chronic Fatigue Syndrome
Best defined as a low-energy state characterized by physical or mental weariness.
- Collagen Vascular Disease
See connective tissue disease.
- Complement
A protein consumed with inflammation and levels may be decrease in Sjögren's.
- Complementary Medicine
Nonprescription use of products found in nature to treat medical conditions. Also includes noninvasive mind body techniques such as biofeedback, acupuncture, yoga.
- Complete Blood Count (CBC)
A blood test measuring the amount of red cells, white blood cells, and platelets in the body.
- Congenital Heart Block
A dysfunction of the rate/rhythm conduction system in the fetal or infant heart caused by antibodies to SSA or SSB.
- Conjunctiva
The mucous membrane covering the outside of the eyeball and the inner lining of the eyelids.
- Connective Tissue Disease
A disorder marked by inflammation of the connective tissue (joints, skin, muscles) in multiple areas. In most instances, connective tissue diseases are associated with autoimmunity.
- Constitutional Symptoms
A symptom that affects the general well-being or general status of a patient. Examples include weight loss, shaking, chills, fever, and vomiting.
- Contrast Sialography
This test assesses the structure of the major salivary glands.
- Cornea
The clear "watch crystal" structure covering the pupil and iris (colored portion of the eye). It is composed of several vital layers, all of which are functionally important. The surface layer, or epithelium, is covered by the tears, which lubricate and protect the surface.
- Corticosteroid
A hormone produced by the adrenal cortex gland. Natural adrenal gland hormones have powerful anti-inflammatory activity and are often used in the treatment of severe inflammation affecting vital organs. The many side effects of corticosteroids should markedly curtail their use in mild disorders.
- Costochondritis
An irritation of a rib and adjoining cartilage and causing chest pain.
- CREST Syndrome
A limited form of scleroderma characterized by C (calcium deposits under the skin), R (Raynaud's phenomenon), E (esophageal dysfunction), S (sclerodactyly or tight skin) and T (a rash called telangiectasia).
- Crossover Syndrome
An autoimmune process that has features of more than one rheumatic disease.
- Crossover Syndrome
An autoimmune process that has features of more than one rheumatic disease.
- Cryoglobulinemia
A condition whereby protein complexes circulating in the blood become deposited during cold weather), and vasculitis (inflammation of blood vessels.
- Cryoglobulins
Protein complexes circulating in the blood that are precipitated during cold.
- Cryptogenic Cirrhosis
Liver disease of unknown etiology (origin) in patients with no history of alcoholism or previous acute hepatitis.
- Cytokine
A group of chemicals that signal cells to perform certain actions.
- Demineralization
The process of removing hard minerals (calcium) from the tooth surface. Progressive removal of these minerals results in a progressive dental cavity. This is part of the dental caries process.
- Demyelination
Areas of damage to the coatings of the nerve fibers.
- Dendritic Cells
Immune cells that form part of the mammalian immune system.
- Dental Caries
A process in which the tooth is gradually dissolved (demineralized) by acids from bacteria attached to the surface, which leads to progressive cavitation. If the caries process is allowed to continue without treatment, it will progress through the tooth into its pulp (containing the nerve of the tooth). Also known as dental decay or cavity.
- Dermatomyositis
An autoimmune process directed against muscles associated with skin rashes.
- Diuretics
Medications that increase the body's ability to rid itself of fluids.
- Docosahaexanoic (DHA)
An omega-3 fatty acid.
- Double Blind Study
One in which neither the physician nor the patients being treated know whether patients are receiving the active ingredient being tested or a placebo (an inactive substance).
- Dysautonomia
Dysautonomia is a broad term that includes all of the different forms of autonomic nervous system dysfunction, including damage to the autonomic nerves, or intact autonomic nerves that aren't working properly. Autonomic nerves help regulate your heart rate, blood pressure, digestion, saliva and tear production, and other "automatic" bodily functions.
- Dysorexia
Impaired or deranged appetite.
- Dyspareunia
Painful sexual intercourse.
- Dyspepsia
Can be defined as painful, difficult, or disturbed digestion, which may be accompanied by symptoms such as nausea and vomiting, heartburn, bloating, and stomach discomfort. (upset stomach).
- Dysphagia
Difficulty in swallowing. In Sjögren’s this may be attributable to several causes, among them a decrease in saliva, infiltration of the glands at the esophageal mucosa, or esophageal webbing.
- Dyspnea
Air hunger resulting in labored or difficult breathing, sometimes accompanied by pain.
- Dysuria
Pain on urination.
- Ecchymosis
A purplish patch caused by oozing of blood into the skin; ecchymoses differ from petechiae in size.
- Edema
Swelling caused by retention of fluid.
- Eicosapaentanoic (EPA)
An omega-3 fatty acid found in fish oils.
- Electromyography (EMG)
A technique for evaluating and recording the electrical activity produced by skeletal muscles.
- ELISA (Enzyme Linked Immunosorbent Assay)
A very sensitive blood test for detecting the presence of autoantibodies.
- Endoscopy
A procedure by which your doctor uses a small, flexible tube called an endoscope, to view your esophagus, stomach and duodenum.
- Epigenetics
An emerging field that studies how these heritable modifications that do not involve changes in the nucleotide sequence lead to altered gene expression.
- Epistaxis
Nosebleed or hemorrhaging from the nose, which may be caused by dryness of the nasal mucous membrane in Sjögren’s.
- Epithelial
The outside layer of cells that covers all the free, open surfaces of the body including the skin, and mucous membranes that communicate with the outside of the body.
- Erythema
A medical term for a red color, usually associated with increased blood flow to an inflamed area, often the skin.
- Erythrocyte
Red blood cell.
- Erythrocyte Sedimentation Rate (ESR)
Measures the degree to which whole blood, collected in tubes containing a chemical that prevents clotting (anticoagulant), separates into plasma (the upper layer) and packed red cells (the lower layer) over the course of one hour. Elevated with inflammation.
- Esophageal Dysmotility
Muscular incoordination of the esophagus. May affect up to 1/3 of SS patients with dysphagia.
- Esophagitis
Prolonged reflux of acid results in chronic irritation of the esophagus.
- Esophagus
A canal (narrow tube) with muscular walls allowing passage of food from the pharynx, or end of the mouth, to the stomach.
- Estrogens
Any of several steroid hormones produced chiefly by the ovaries and responsible for promoting estrus and the development and maintenance of female secondary sex characteristics.
- Etiology
The cause(s) of a disease.
- Eustachian Tube
The tube running from the back of the nose to the middle ear.
- Exocrine Glands
Glands that secrete outside the body (e.g. lacrimal, salivary or sweat glands).
- Exocrinopathy
Disease related to the exocrine glands.
- Extraglandular
Outside of the glands.
- Fibromyalgia
A form of non-neuropathic chronic neuromuscular pain associated with fatigue, disordered sleeping, and tender points in the soft tissues.
- Fibrosis
Abnormal formation of fibrous tissue.
- Filamental Keratopathy
Mucus strands stick to the cornea at sites of focal desiccation and surface cells extend onto the strand making it very adherent to the cornea causing discomfort or even pain when blinking pulls on the strand.
- Fissure
A crack in the tissue surface (skin, tongue, etc.).
- Fluorescein Stain
A dye that stains areas of the eye surface in which cells have been lost.
- Focal Lymphocytic Sialoadenitis
A characteristic pattern of inflammation.
- Gastritis
Stomach inflammation.
- Gastro-Esophageal Reflux (GERD)
Muscle tone in the wall of the esophagus is reduced, gastric juice moves up the esophagus, producing a burning sensation behind the breastbone (heartburn) and chest pain.
- Gene
Consisting of DNA, it is the basic unit of inherited information in our cells that control the physical traits that are passed from parents to their offspring.
- Gene Therapy
A method of treating disease by introducing normal DNA directly into cells to correct a genetic defect that is causing the disease.
- Gene Transfer
The insertion of unrelated genetic information in the form of DNA into cells.
- Genetic Factors
Traits inherited from parents, grandparents, and so on.
- Genetics
Broadly refers to the study of genes.
- Genome
All of the genetic information, the entire genetic complement, all of the hereditary material possessed by an organism.
- Genome-Wide Association Study (GWAS):
Allows the scientist to rapidly scan the complete set of DNA, or genome, of many individual people to find genetic variations associated with a complex disease, such as Sjögren’s.
- Gingiva
The gums.
- GIngivitis
Inflammation of the gums.
- Globulin
A protein whose levels increase in inflammation.
- Glomerulonephritis
Inflammation of the kidney.
- Goblet Cell
Any of the specialized epithelial cells found in the mucous membrane of the stomach, intestines, and respiratory passages that secrete mucus.
- Granulocytes
A type of white blood cell.
- Granuloma
A nodular, inflammatory lesion.
- Grave's Disease
A form of autoimmune thyroid disease.
- Halitosis
Bad breath.
- Hashimoto’s Thyroiditis
The most common form of thyroiditis and the most frequent cause of hypothyroidism.
- Helicobacter Pylori
A common chronic bacterial infection of the stomach. Associated with increased risk of gastrointestinal (MALT)lymphoma.
- Hepatitis
Inflammation of the liver; seen in Sjögren’s patients who have biliary cirrhosis.
- Hepatitis C Virus
Not associated with Sjögren’s but can present with sicca symptoms mimicking Sjögren's.
- Homeopathy
A method of treating disease with small amounts of remedies that, in large amounts in healthy people, produce symptoms similar to those being treated.
- Hormone Replacement Therapy (HRT):
Therapy with estrogen and progesterone that is commonly used in menopause for severe hot flashes, disrupted sleep, and in some cases mild depressive symptoms.
- Hormones
Chemical messengers--including thyroid, insulin, steroids, estrogen, progesterone and testosterone---made by the body.
- Hydroxychloroquine
Anti-inflammatory drug (trade name Plaquenil) used in the treatment of autoimmune conditions such as rheumatoid arthritis, Sjögren’s and lupus erythematosus.
- Hyperalgesia
An extreme reaction to a stimulus that is not normally painful.
- Hypergammaglobulinemia
A medical condition with elevated levels of gamma globulin.
- Hypergammaglobulinemic Purpura
A type of skin rash, which is a purple brown color.
- Hypokalemia
Low potassium.
- Hypothyroidism
A condition in which the thyroid gland does not make enough thyroid hormone.
- Idiopathic
Of unknown cause.
- Immunogenetics
The study of genetic factors that control the immune response.
- Immunoglobulin E (IgE):
Antibody associated with allergies.
- Immunoglobulins (Gamma Globulins)
The protein fraction of serum responsible for antibody activity. Measurement of serum immunoglobulin levels can serve as a guide to disease activity in some patients with Sjögren’s.
- Immunomodulators
Medications that affect the body's immune system.
- Immunosuppressive Agents
A class of drugs that interferes with the function of cells composing the immune system. Drugs used in the chemotherapy of malignant disease and in the prevention of transplant rejection are generally immunosuppressive and occasionally are used to treat severe autoimmune disease. Also see lymphocyte.
- Incisal
Cutting edge (of a tooth).
- Indigestion (Dyspepsia)
A painful or burning feeling in the upper abdomen and is usually accompanied by nausea, bloating or gas, a feeling of fullness, and, sometimes, vomiting.
- Innate Immunity
Primitive responses to bacteria and viruses via a pattern recognition mechanism.
- Interferon
A protein made to protect the body from infection that is overactive in Sjögren's.
- Interstitial
Supporting structure of the substance of an organ or tissues.
- Interstitial Cystitis
Inflammation of the bladder.
- Interstitial Lung Disease
When the lung itself becomes inflamed.
- Interstitial Nephritis
Inflammation of the connective tissue of the kidney, usually resulting in mild kidney disease characterized by frequent urination. Interstitial nephritis is the most common renal problem in patients with Sjögren’s.
- Interstitial Pneumonitis
An inflammation of the supporting tissue around the alveoli (air sacs) of the lungs caused by the autoimmune process.
- Intraoral
Inside the mouth.
- Intrathoracic
Within in the cavity of the chest.
- Irritable Bowel Syndrome
Spastic colitis or irritable bowel.
- IV Immunoglobulin or IVIg
A blood product made from the plasma component of blood pooled from thousands of donors. It contains immunoglobulins, which interact with the immune system in order to suppress it.
- Jaundice
Yellowing of the skin.
- Keratoconjunctivitis Sicca
Condition, also called dry eye, that most frequently occurs in women in their forties and fifties. If it is associated with a dry mouth and/or rheumatoid arthritis, the condition is referred to as Sjögren’s.
- Lacrimal
Relating to the tears.
- Lacrimal Glands
Two types of glands that produce tears. Smaller accessory glands in the eyelid tissue produce the tears needed from minute to minute. The main lacrimal glands, located just inside the bony tissue surrounding the eye, produce large amounts of tears.
- Laryngopharyngeal Reflux (LPR):
Reflux of gastric contents and acids to the level of the throat, can lead to symptoms of hoarseness, chronic cough, throat clearing, mild pharyngeal dysphagia, or globus sensations (sensation of a lump or foreign body in the throat).
- Laryngotracheobronchitis
An acute respiratory infection involving the larynx, trachea, and bronchi. Also called croup.
- Larynx
Voice box.
- Latent
Not manifest but potentially discernible.
- Leukopenia
Low numbers of white cells.
- Leukorrhea
A whitish, viscid discharge from the vagina and uterine cavity.
- Lip Biopsy
Incision of approximately 2 cm on the inside surface of the lower lip and excision of some of the minor salivary glands for microscopic examination and analysis.
- Lissamine Green
A vital stain with dyeing quality similar to that of Rose Bengal, but which causes less discomfort. It stains dead or degenerated epithelial cells green and is used to facilitate the diagnosis of keratoconjunctivitis sicca, xerophthalmia, etc.
- Lymph
A fluid collected from the tissues throughout the body, flowing through the lymph nodes and eventually added to the circulating blood.
- Lymphadenopathy
Abnormally enlarged lymph nodes. Commonly called "swollen glands."
- Lymphocyte
A type of white blood cell concerned with antibody production and regulation. Collections of lymphocytes are seen in the salivary glands of Sjögren’s patients.
- Lymphoma
A proliferation (increase) of abnormal (malignant) lymphocytes that has many different types. Two of those types are known to develop in a small proportion of Sjögren’s patients: MALT (mucosa-associated lymphoid tissue) lymphoma (also called extra nodal marginal zone lymphoma), which is very slow growing, may cause progressive salivary gland enlargement, and is rarely fatal; the other type, large B-cell lymphoma occurs even less frequently, but can be aggressive.
- Lymphoproliferation
The excessive production of lymphocytes.
- Macrophage
A cell that kills foreign material and presents information to lymphocytes.
- MALT (Mucosa-Associated Lymphoid Tissue)
Associated with the mucosa, the moist lining of some organs and body cavities. MALT refers to the most common type of lymphoma in Sjögren’s.
- Manometry
The diagnosis of dysmotility is made by measuring the pressure inside the wall of the esophagus during swallowing.
- Matrix
The section of the tooth enamel that holds calcium and phosphate minerals.
- Meibomian Glands
Fat-producing glands in the eyelids that produce an essential component of tears.
- MHC
Major histocompatibility complex. In humans, it is the same as HLA.
- Mixed Connective Tissue Disease
A connective tissue disease that manifests as an overlap of other connective-tissue disorders.
- Mucin
Thinnest layer of the tear film; layer closest to the cornea.
- Mucolytic Agents
Medications that tend to dissolve mucus. Most patients with dry eye complain of excess mucous discharge. Some patients may benefit from these medications if other tear-film enhancing drops are not very effective.
- Myalgia
Muscle pains.
- Necrosis
Tissue death.
- Neonatal Lupus Syndrome
A rare autoimmune disorder that is present at birth in patients with anti SSA or SSB and usually manifests itself with a rash or hear block.
- Nephritis
An inflammation of the kidneys.
- Nerve Conduction Study
A test commonly used to evaluate the function, especially the ability of electrical conduction, of the motor and sensory nerves of the human body.
- Neutrophil
A granulated white blood cells involved in bacterial killing and acute inflammation.
- Nonspecific
Caused by other diseases or multiple factors.
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDS):
Anti-inflammatory agents blocking the action of prostaglandins used to treat pain that occur in rheumatoid arthritis and other connective-tissue disorders. Examples include ibuprofen (Motrin, Advil) and naproxen (Aleve).
- Norepinephrine
A hormone and neurotransmitter secreted by the adrenal medulla and the nerve endings of the sympathetic nervous system to cause vasoconstriction and increases in heart rate, blood pressure, and the sugar level of the blood.
- Olfactory
Relating to the sense of smell.
- Ophthalmologist
A physician who specializes in diseases and surgery of the eye.
- Optic Neuritis
The inflammation of the optic nerve that may cause a complete or partial loss of vision.
- Oral Mucosa
The lining (mucous membrane) of the mouth.
- Oral Soft Tissue
Tongue, mucous lining of the cheeks, and lips.
- Orthostasis
Maintenance of an upright standing posture.
- Otalgia
Ear pain.
- Otitis
Inflammation of the ear, which may be marked by pain, fever, abnormalities of hearing, deafness, tinnitus (a ringing sensation), and vertigo. In Sjögren’s, blockage at eustachian tubes due to infection can lead to conduction deafness and chronic otitis.
- Otolaryngologist
Physician specializing in ear, nose, and throat disorders.
- Palate Biopsy
A punch biopsy near the junction of the hard and soft palates to sample the minor salivary glands in that region.
- Palpable
Perceptible to touch.
- Palpable Purpura
Rashes, particularly eruptions of small red raised on the extremities that can cause skin changes in SS patients.
- Pancreatitis
Acute inflammation of the pancreas.
- Parasympathetic Nervous System
The part of the autonomic nervous system whose functions include constriction of the pupils of the eyes, slowing of the heartbeat, and stimulation of certain digestive glands. These nerves originate in the midbrain, the hindbrain, and the sacral region of the spinal cord; impulses are mediated by acetylcholine.
- Parotid Gland Flow
An empirical quantitative measure of the amount of saliva produced over a certain period of time. Normal parotid gland flow rate is 1.5 ml/min. In Sjögren’s, the flow rate is approximately 0.5 ml/min, with diminution of the flow rate correlating inversely with the severity of disease.
- Parotid Glands
One of the three pairs of major salivary glands. They are located in front of the ear.
- Parotid Scintigraphy
This is a nuclear medicine test that evaluates the function of the parotid and submandibular gland.
- Pathogenesis
The development of a disease.
- Peptides
Any of various natural or synthetic compounds containing two or more amino acids linked by the carboxyl group of one amino acid to the amino group of another.
- Perforation
A hole.
- Pericarditis
Inflammation of the lining around the heart (the pericardium).
- Pericardium
The lining of the heart.
- Perimenopause
A variable time of irregular menses beginning a few years before the menopause.
- Periodontitis
Inflammation of the gums and soft tissue and bone surrounding and supporting the teeth.
- Peripheral Nerves
Nerves outside the central nervous system.
- Peripheral Neuropathy
A problem with the nerves that carry information to and from the brain and spinal cord. This can produce pain, loss of sensation, and an inability to control muscles.
- Pernicious Anemia
A blood disorder caused by inadequate vitamin B12 in the blood.
- Petechia
A small, pinpoint, nonraised, perfectly round, purplish red spot caused by intradermal or submucosal hemorrhaging.
- Phagocytic Cells
Cells, such as a white blood cells, that engulfs and absorbs waste material, harmful microorganisms, or other foreign bodies in the bloodstream and tissues.
- Pharynx
Throat.
- Photosensitivity
Sensitivity to ultraviolet light.
- Placebo
An inactive substance used as a “dummy” medication.
- Plaque
A thin, sticky film that builds up on the teeth, trapping harmful bacteria.
- Plasma
The fluid portion of the circulating blood.
- Plasmapheresis
Filtration of blood plasma through a machine to remove proteins that may aggravate Sjögren's.
- Pleura
A sac lining the lung.
- Pleurisy
Inflammation of the pleura (membrane surrounding the lungs and lining the walls of the rib cavity).
- Polychondritis
Inflammation and destruction of the cartilage of various tissues of the body.
- Polyclonal
Derived from different cells.
- Polymyositis
A connective tissue disorder characterized by muscle pain and severe weakness secondary to inflammation in the major voluntary muscles.
- Polysomnography
Sleep study.
- Primary Biliary Cirrhosis (PBC)
Impairment of bile excretion secondary to liver inflammation and scarring.
- Probiotics
The administration of good bacteria which kills bad gut bacteria.
- Progestins
Any one of a group of steroid hormones that have the effect of progesterone.
- Prostaglandins
Produced by the body and are responsible for inflammation features, such as swelling, pain, stiffness, redness and warmth.
- Protein
A collection of amino acids. Antibodies are proteins.
- Proteinuria
Excess protein levels in the urine (also called albuminuria).
- Proteomics
The study of proteins.
- Pruritis
Itching.
- Psoralen
A drug administered orally or topically for the treatment of vitiligo (white patches caused by loss of pigment).
- Puncta
Small holes in the eyelids that normally drain tears. Patients with severe dry eye benefit from punctal closure, which allows maximal tear preservation.
- Punctal Plugs
Inserted to increase the volume of tears retained on the surface of the eye also may be needed to allow continued lens wear.
- Purpura
A condition characterized by hemorrhage into the skin, appearing as crops of petechiae (very small red spots).
- Radioactive Isotope
Radioactive material used in diagnostic tests.
- Radionuclide Studies
A technique in which radioactive isotopes, such as radiolabeled human serum albumin, are injected into an organ. A gamma scintillation camera, coupled with a digital computer system and a cathode ray display, reads the radioactive emissions. Areas of perfusion will show marked radiographic emissions; areas of obstruction will show no activity.
- Raynaud’s Phenomenon
Painful blanching of the fingertips on exposure to cold. This may be seen alone or in association with a connective tissue disease such as Sjögren’s.
- Reflux
A regurgitation due to the return of gas, fluid, or small amount of food from the stomach.
- Regulatory Immunity
Needed to evolve to facilitate termination of a no-longer-needed adaptive response and, as well, to limit responses to ‘self’ (auto) antigen.
- Remineralization
The process of restoring minerals (calcium and phosphate) to the tooth surface.
- Renal
Relating to the kidneys.
- Renal Tubular Acidosis
Damage of the tubules of the kidney which lowers pH and is associated with renal damage.
- Restless Legs Syndrome
Characterized by unpleasant sensations in the limbs, usually the legs, that occur at rest or before sleep and are relieved by activity such as walking.
- Rheumatoid Arthritis (RA)
An autoimmune disease and form of arthritis characterized by inflammation of the joints, stiffness, swelling, synovial hypertrophy, and pain. Sjögren’s frequently occurs in conjunction with RA.
- Rheumatoid Factor
An autoantibody whose presence in the blood usually indicates autoimmune activity.
- Rheumatologist
A physician skilled in the diagnosis and treatment of rheumatic conditions.
- Rosacea
A chronic dermatitis of the face, especially of the nose and cheeks, characterized by a red or rosy coloration with deep-seated papules and pustules and caused by dilation of capillaries. Can be mistaken for lupus or anti SSA associated rashes.
- Rose Bengal
A dye that stains abnormal cells on the surface of the eye. When used for diagnosis in patients with significant dry eyes (keratoconjunctivitis sicca), it is very irritating and its use has been generally replaced by the use of lissamine green, an equivalent dye that is not irritating.
- Salicylates
Aspirin-like drugs.
- Salivary Flow Rate
The amount of saliva naturally produced by the salivary glands.
- Salivary Glands
Exocrine glands (parotid, submandibular, and sublingual) with ducts, that produce saliva.
- Salivary Scintigraphy
Measurement of salivary gland function through injection of radioactive material.
- Sarcoidosis
A systemic disease with granulomatous (nodular, inflammatory) lesions involving the lungs and, on occasion, the salivary glands, with resulting fibrosis.
- Schirmer's Test
The standard objective test to diagnose dry eye. Small pieces of filter paper are placed between the lower eyelid and eyeball and soak up the tears for five minutes. The value obtained is a rough estimation of tear production in relative terms. Lower values are consistent with dry eye. It is important to emphasize that no single test can be considered diagnostic unless the condition is severe.
- Scleroderma
A connective tissue and autoimmune disease characterized by thickening and hardening of the skin. Sometimes internal organs (intestines, kidneys) are affected, causing bowel irregularity and high blood pressure. Sjögren’s is not uncommon in patients with scleroderma.
- Sclerosing Cholangitis
A chronic disorder of the liver in which the ducts carrying bile from the liver to the intestine, and often the ducts carrying bile within the liver, become inflamed, thickened, scarred (sclerotic), and obstructed.
- Sclerosing Sialedenitis
Swelling and inflammation of the salivary glands with scarring.
- Secretogogue
A medication that can stimulate salivary flow.
- Serotonin
A chemical produced by the brain that functions as a neurotransmitter. It plays a part in the regulation of mood, sleep, learning and constriction of blood vessels (vasoconstriction).
- Serum
The fluid portion of the blood (obtained after removal of the fibrin clot and blood cells), distinguished from the plasma in the circulation blood.
- Serum Protein Electrophoresis
A laboratory test that examines specific proteins in the blood called globulins. A measurement and breakdown of albumin and globluons.
- Serum Sickness
A delayed allergic reaction to the injection of an antiserum caused by an antibody reaction to an antigen in the donor serum.
- Sialochemistry
Measurement of the constituents in saliva.
- Sialography
X-ray examination of the salivary duct system by use of liquid contrast medium. Radiologically sensitive dye is placed into the duct system, outlining the system clearly.
- Sicca
An autoimmune disease, also known as Sjögren's, that classically combines dry eyes, dry mouth, and another disease of connective tissue such as rheumatoid arthritis (most common), lupus, scleroderma or polymyositis.
- Signs
Changes that can be seen or measured.
- Sinusitis
Sinus inflammation.
- Sjögren’s Antibodies
Abnormal antibodies found in the sera of Sjögren’s patients. These antibodies react with the extracts of certain cells, and a test based on this principle can be helpful in the diagnosis of Sjögren’s. See also SSA and SSB.
- Sjögren’s Syndrome (SS)
A systemic multi-organ autoimmune disease that generally has a chronic or progressive course and is characterized by, but not limited to, secretory dysfunction. It may occur alone or precede or follow the occurrence of other autoimmune diseases in the same patient.
- SLE (Systemic Lupus Erythematosus)
An inflammatory connective tissue disease.
- SSA
Sjögren’s syndrome–associated antigen A (anti Ro).
- SSB
Sjögren’s syndrome–associated antigen B (anti La).
- Steatorrhea
Passage of large amounts of fat in the feces, as occurs in pancreatic disease and the malabsorption syndromes.
- Steroids
Cortisone-derived medications.
- Subacute Cutaneous Lupus (SCLE)
A unique set of photosensitive rashes, originally described in patients with lupus, may occur in Sjögren’s and are common in patients with anti-SSA (Ro) and anti-SSB (La) antibodies.
- Sublingual Glands
One of the three pairs of major salivary glands. They are located in the floor of the mouth under the tongue.
- Submandibular Glands
One of the three pairs of major salivary glands. They are located below the lower jaw.
- Symptoms
Changes patients feel.
- Synovitis
Inflammation of the tissues lining a joint.
- Synovium
Tissue that lines a joint.
- Systemic
Any process that involves multiple organ systems throughout the body.
- Systemic Lupus Erythematosus (SLE)
An autoimmune disease that is closely related to Sjögren’s syndrome, occurs frequently in conjunction with Sjögren’s, and can damage any body organ or system.
- T cell
A lymphocyte (white blood cell) responsible for immunologic memory.
- Tear Breakup Test
Measurement of tear breakup time is a standard part of the evaluation of dry eye since instability of the tear film is a characteristic of both forms of dry eye.
- Tear Film
Protects and lubricates the cornea and the rest of the ocular surface. Natural tears are mostly water containing a complex mixture of proteins and other components.
- Tear Osmolarity Test
Tear osmolarity testing measures the concentration of the tear film which can be elevated in either aqueous deficient or evaporative dry eye.
- Thrombocytopenia
Low platelet counts.
- Thrush
A form of candidiasis. Infection of the oral tissues with Candida albicans.
- Thymus
A gland in the neck responsible for immunologic memory.
- Thyroiditis
A disease in which autoantibodies cause immune system cells (lymphocytes) to destroy the thyroid gland.
- Tinnitus
Ringing in the ears.
- Titer
Test showing the strength or concentration of a particular volume of a solution. Usually refers to amounts of antibody present.
- TMJ (Temporomandibular Joint)
The joint of the lower jaw where the ball-and socket arrangement is formed by the condyle of the lower jaw (the ball) and the fossa of the temporal bone (the socket). The joint space is filled with synovial or lubricating fluid. This joint and the surrounding synovial tissues may become inflamed if rheumatoid arthritis accompanies Sjögren’s and involves the joint.
- Tolerance
The failure to make antibodies to an antigen.
- Toll Receptor
A pattern-recognition feature of the innate immune system.
- Trachea
Windpipe.
- Tracheobronchial Tree
The windpipe and the bronchi into which it subdivides.
- Trigeminal Nerve
The chief nerve of sensation for the face and the motor nerve controlling the muscles of mastication (chewing).
- Tubulointerstitial Nephritis
See interstitial nephritis.
- Tumor Necrosis Factor (TNF)
A cytokine produced primarily by monocytes and macrophages that promotes inflammation.
- UCTD (Undifferentiated Connective Tissue Disease)
Features of autoimmunity such as inflammatory arthritis or Raynaud’s in a patient who does not meet the ACR criteria for lupus, rheumatoid arthritis or other disorders.
- Ultraviolet Light (UV Light)
A spectrum of light including UVA (320–400 nanometers), UVB (290–320 nanometers), and UVC (200–290 wavelengths).
- Urinalysis
Examination of urine under a microscope.
- Urticaria
Hives.
- Vasculitis
Inflammation of a blood vessel.
- Venous Thromboses
Clots in veins of the of the lower extremities and less frequently the lungs.
- Venule
A very small vein.
- Viscera
The organs of the digestive, respiratory, urogenital, and endocrine systems, as well as the spleen, heart, and great vessels (blood and lymph ducts).
- Vitamin B12 Deficiency
A reduction in vitamin B12 from inadequate dietary intake or impaired absorption.
- Vitamin D
A fat-soluble vitamin that enhances the absorption of calcium and phosphorus from the intestine and promotes their deposition onto the bone.
- Vitiligo
White patches on the skin due to loss of pigment.
- WBC
White blood cell.
- Xerophthalmia
Dry eyes.
- Xerostomia
Dryness of the mouth caused by the arresting of normal salivary secretions. It occurs in diabetes, drug therapy, radiation therapy, and Sjögren’s.
- Xserosis
Abnormal dryness of the skin (xerderma), of the conjunctiva of the eye (xerophtalmia), or of the mucous membranes such as dry mouth (xerostomia).
- Xylitol
sweetening agent with cariostatic properties.