Comorbidities in Sjogren's
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As with other systemic inflammatory diseases, Sjogren’s patients are at elevated risk for serious infections, strokes, heart attacks and osteoporosis. Infections and cardiovascular disease disease are a significant causes of premature mortality (early death) in Sjogren’s patients (24, 42, 47).
Comorbidities: autoimmune and autoinflammatory
Autoimmune connective tissue diseases such as rheumatoid arthritis (RA) or systemic lupus may accompany Sjogren's. There are other autoimmune and autoinflammatory diseases (e.g., spondylitis) that Sjogren’s patients are also more likely to experience than the general population.
When two major rheumatologic diseases occur together, each deserves specific management. The correct term to describe a patient with Sjogren's that occurs together with RA is "Sjogren's associated with RA." The outdated term “Secondary Sjogren’s” is misleading and should not be used in this situation. (122, 123)
Other autoimmune conditions
Hashimoto’s thyroiditis and celiac disease occur at much higher rates in Sjogren’s patients than in the general population. Anti-phospholipid antibodies (APA), more often seen in SLE, do occur in some Sjogren’s patients. APA positive patients are at increased risk of developing blood clots, strokes, heart attacks and pregnancy complications. Sjogren’s patients should be screened for all three diseases.
Monitoring and prevention of all types of comorbidities is an important component of good Sjogren’s care.