Sjögren's syndrome: Infections that may play a role in pathogenesis, mimic the disease, or complicate the patient's course

Sjögren's syndrome (SS) is a systemic autoimmune disorder characterized by lymphocytic infiltration of the lacrimal and salivary glands, leading to dryness of the eyes and mouth. Epidemiologic studies have indicated a role of both genetic and environmental factors in pathogenesis. It is likely that viral infection can create an inflammatory microenvironment that alters the disposition of apoptic fragments that serve as autoantigens. Thus, the search for a single viral agent that is causative is likely to prove difficult. Attention has focused on viruses that have tropism for the salivary and lacrimal glands, particularly members of the herpesvirus family. Other infectious agents too may mimic the clinical appearance of SS or complicate the disease. This article reviews the role of infections in patients with Sjogren's syndrome.