Sjögren’s syndrome

• Primary Sjögren’s (dry eyes and mouths only)
• Secondary Sjögren’s (associated with other immune disorders)

• 710.2 Sicca syndrome
• PT diagnoses/treatment diagnoses that may be associated with immune disorders affecting movement
  • 315.4 Developmental coordination disorder
  • 718.07 Articular cartilage disorder, ankle and foot
  • 718.03 Articular cartilage disorder, forearm
  • 718.04 Articular cartilage disorder, hand
  • 718.45 Contracture of joint, pelvic region and thigh
  • 719.39 Palindromic rheumatism involving multiple sites
  • 719.4 Pain in joint
  • 728.2 Muscular wasting and disuse atrophy, not elsewhere classified
  • 729.9 Other and unspecified disorders of soft tissue
  • 729.1 Myalgia and myositis, unspecified
  • 729.9 Other disorders of soft tissue
  • 736.9 Acquired deformity of limb site unspecified
  • 780.7 Malaise and fatigue
  • 781.2 Abnormality of gait
  • 782.3 Edema
  • 786.0 Dyspnea and respiratory abnormalities
  • 786.05 Shortness of breath
  • 728.89 Other disorders of muscle, ligament, and fascia

• M35.00 Sicca syndrome, unspecified
• M35.01 Sicca syndrome with keratoconjunctivitis

• 4D: Impaired joint mobility, motor function, muscle performance, and range of motion associated with Connective Tissues Dysfunction
• 4E: Impaired joint mobility, motor function, muscle performance, and range of motion associated with localized inflammation
• 7B: Impaired integumentary integrity associated with superficial skin involvement

Description

• Condition in which healthy tissue is mistaken by the body as foreign substances
• Affects the exocrine glands
• Limits production of body secretions
• Multiple body system involvement
• Onset often vague with misdiagnosis

Essentials of Diagnosis

• Must be made by a physician and confirmed by medical diagnostic testing
• History
• Presence of markers
• Dry eyes and mouth
• Elimination of other diseases

General Considerations

• Specific diagnosis may take time and require intensive medical diagnostic testing
• May result in secondary problems such as
  • Aerobic capacity and muscle endurance impairment
  • Sarcopenia
  • Weakness/impaired muscle performance
  • Musculoskeletal problems
  • Neuromuscular problems
  • Weight loss, indicating the need for PT intervention depending on severity
• Because Sjögren’s and other immune disorders frequently refer pain or are causative of pain in various body areas, individuals may get referred to PT inappropriately or appropriately; inappropriate referral may be such as when referred to the lower back or upper back or chest
• History of heartburn or indigestion may be indicative of GI or cardiac problems or directly related to Sjögren’s

Demographics

• Females more likely than males
• Adults > 40 years of age
• Can affect individuals of all ages, but is rare in children
• Some indication of genetic familial tendency
• More likely if there is a systemic rheumatic disease such as systemic lupus erythematosus (SLE) or rheumatoid arthritis
• Estimated 1 to 4 million in U.S.

Signs and Symptoms

• The signs and symptoms indicated below may be characteristic of multiple immune systemic disorders, often confounding medical diagnosis
• It is not the purview of a PT to medically diagnose an immune pathology but rather to recognize the possibility in the differential diagnosis process, especially when ...