Understanding Juvenile Sjögren’s Syndrome
Juvenile Sjögren’s Syndrome (JSS) is a rare autoimmune disease in which the body’s immune system attacks the glands that produce tears and saliva. Though it’s more common in adults, it can also affect children and teenagers, often presenting differently from adults.
In children, it may appear alone (primary) or alongside other conditions such as lupus or juvenile arthritis (secondary Sjögren’s).
Common Signs and Symptoms
- Dry Eyes (Keratoconjunctivitis Sicca)
- Burning, itching, or “gritty” feeling in the eyes
- Increased blinking
- Light sensitivity
- Dry Mouth (Xerostomia)
- Difficulty swallowing dry foods
- Cracked lips or mouth ulcers
- Increased dental cavities
- Swelling of the Parotid Glands
Recurrent, painless swelling of the cheeks due to enlarged saliva glands is a classic sign.
- Fatigue and Joint Pain
Many children report feeling tired, with joint aches that mimic arthritis.
- Other Possible Symptoms
- Dry skin or vaginal dryness (in older girls)
- Abdominal pain
- Fever or rash in systemic cases
Red Flags to Watch For
- Persistent dry eyes or mouth not explained by dehydration
- Recurrent cheek swelling
- Frequent dental cavities despite good oral hygiene
- Fatigue and joint pain with no clear cause
- Associated autoimmune diseases (like lupus or arthritis)
Diagnosis
- Clinical Evaluation
History and examination of dryness and gland enlargement.
- Special Tests
- Schirmer’s test: Measures tear production.
- Salivary flow test: Measures saliva quantity.
- Blood tests: ANA, anti-SSA/Ro, and anti-SSB/La antibodies.
- Salivary gland ultrasound or biopsy for confirmation.
Treatment and Management
Symptom Control
- Artificial tears and saliva substitutes for comfort.
- Good oral hygiene and regular dental checkups.
- Sugar-free chewing gum or lozenges to stimulate saliva.
Medications
- Hydroxychloroquine for fatigue, joint pain, or rash.
- Immunosuppressants in severe or systemic disease.
Lifestyle Measures
Encourage hydration, eye protection, and limiting caffeine or alcohol (which worsen dryness).
Why Early Recognition Matters
Early management prevents long-term gland damage, dental decay, and eye injury. It also helps screen for associated autoimmune diseases that may emerge later.
Hope Arthritis Foundation’s Commitment
Through our education and advocacy programs, we empower parents and health workers to recognize subtle signs of autoimmune diseases in children, including juvenile Sjögren’s.
Together, we’re ensuring that no child’s silent symptoms go unnoticed.
Written by:
Dr. Angela Migowa, MD, PhD
Pediatric Rheumatologist & Founder, Hope Arthritis Foundation