An Impaired Sense of Smell Is Common in Sjögren’s Syndrome, and Could Indicate Higher Disease Activity

Lost your sense of smell? While your first thought might be to get a COVID test (not a bad idea), Sjögren’s syndrome should also be on your radar.

Sjögren’s syndrome is an autoimmune condition that primarily impacts the salivary and tear glands. That explains why dry mouth and dry eyes are among the most common Sjögren’s symptoms, but those aren’t the only possible tip-offs. Many people with this condition report overwhelming fatigue, brain fog, dry and itchy skin, swollen glands in the jaw, and a persistent cough.

Some also notice a partial or total loss of their sense of smell.

Past research has found that people with Sjögren’s syndrome develop problems with their sense of taste and/or smell more frequently than those in the general population. Now a new study, published in the journal Arthritis Research & Therapy, reaches the same conclusion and also suggests that Sjögren’s patients who have this particular symptom might have higher levels of disease activity than others who do not experience a change in their senses.

The study was fairly small, as it only consisted of 52 people with Sjögren’s plus healthy control subjects. The researchers conducted a variety of smell tests during which participants were asked to identify and recall different odors.

The researchers determined that 13.5 percent of the Sjögren’s patients had anosmia (no sense of smell) and 19 percent had hyposmia (reduced sense of smell). None of the members of the control group had anosmia, though 12 percent had hyposmia.

Disease activity was assessed using the EULAR Sjögren’s Syndrome Disease Activity Index (ESSDAI) as well as the EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI). (EULAR stands for European Alliance of Associations for Rheumatology. It is a professional organization that represents rheumatology health professionals, European nation rheumatology scientific societies, and people with rheumatic diseases.)

Together, these measures provide extensive information about a Sjögren’s patient’s overall health and functioning, including whether someone has developed lung, liver, nerve, or kidney problems, among other possible complications. The researchers found that disease activity was higher in those who had impaired or non-existent sense of smell compared to other people with Sjögren’s who did not have this problem.

The study did not reveal any notable connection between smell scores and the type of treatments a given patient was using.

“Although the exact mechanism of olfactory impairment has yet to be elucidated, the possibility of an immune/inflammation-mediated mechanism is intriguing. Therefore, physicians are encouraged to perform routine smell test in patients with [Sjögren’]s and educate them on methods to cope with it for better quality of life,” the authors concluded.

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