Brief Answer:
Sjogrens Syndrome

Detailed Answer:
Good evening

Thank you for writing on health care magic

Well, sjogrens syndrome does cause a big nuisance as it dries up all the salivary and lacrimal glands( eyes) along with dryness of your trachea, food pipe and other parts.

To approach this, there are 2 ways :

1. I would like to know if the lip gland biopsy has been done for your daughter? If there is active inflammation going on in it, she can benefit from a short course of steroids along with hydroxychloroquine which can reduce the inflammation and produce some saliva

2. I understand she did not tolerate Cevimeline. That does usually help in increasing the secretions. The other alternative is to try Pilocarpine. Start it at a low dose( 5 mg half tablet twice daily) and then we can increase it full dose.

3. She can even try putting pilocarpine drops or cevimeline drops in the mouth( more like a topical application).

But yes, first and foremost is to check for inflammation and if we can reduce it, results can be good

Hope the information was useful

Do let me know for more queries

REgards
Dr NAval

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