Pathology

The salivary and lacrimal glands become infiltrated with lymphocytes and the acini progressively destroyed. The majority of lymphocytes are T cells with a predominance of T helper\inducer cells (CD4).

The epithelium of the ducts become hyperplastic, forming casts within the lumen and blocking smaller ducts. Mucous gland metaplasia of the duct epithelium may give rise to a gelatinous saliva in some patients. Strictures, duct dilatations and ascending infection complicate the picture.

B cell hyperactivity - circulating autoantibodies are characteristic of Sjogren's syndrome. Antibodies are directed against non-organ specific antigens such as immunoglobulins (rheumatoid factors) and small cytoplasmic ribonucleoprotein (anti-Ro and anti-La). These autoantibodies do not appear to have a pathogenetic role.