Comorbidities: general

As with other systemic inflammatory diseases, Sjogren’s is associated with an elevated risk for serious infections, strokes, heart attacks, and osteoporosis. Infections and cardiovascular disease are a significant cause of premature mortality (early death) in Sjogren’s patients (24, 42, 47).

Comorbidities: autoimmune and autoinflammatory

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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 The outdated term “Secondary Sjogren’s” is misleading and should not be used (122, 123).

Non-rheumatologic autoimmune conditions such as Hashimoto’s thyroiditis and celiac disease occur at much higher rates in Sjogren’s patients than they do in the general population. Anti-phospholipid antibodies (APA), more common 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 thyroid disease, celiac and APA.

Updated 3-15-21