Background
Sjögren’s syndrome is a systemic autoimmune disorder characterized predominantly by exocrine gland dysfunction, resulting in ocular and oral dryness, and may be associated with inflammatory musculoskeletal and systemic manifestations. There is no direct one-to-one Ayurvedic disease entity corresponding to Sjögren’s syndrome. Its clinical presentation may therefore be interpreted using a phenotype-based Ayurvedic approach involving multiple classical disease principles.
Table of Contents
Case Presentation
A 40-year-old female with serologically supported Sjögren’s syndrome presented with prominent sicca symptoms, inflammatory joint pain and fatigue. Antinuclear antibody (ANA) and anti-SSA/Ro antibodies were positive. Baseline inflammatory markers were significantly elevated, with C-reactive protein (CRP) of 48 mg/L and erythrocyte sedimentation rate (ESR) of 60 mm/hr.
From an Ayurvedic perspective, the clinical presentation was interpreted as a Vāta-predominant inflammatory phenotype characterized by marked Rukṣatā with associated Rakta involvement. The combination of pronounced dryness and inflammatory musculoskeletal manifestations was considered clinically comparable to a Vātarakta-like phenotype. Based on this phenotype, selected principles of Vātarakta management were incorporated into the therapeutic strategy.
Intervention
The patient was treated with Bala-Śatāvarīādi Kaṣāya as systemic therapy and Bālā-Gulūcyādi Śiro-picū as an adjunctive local intervention.
The therapeutic rationale was directed toward addressing the predominant clinical qualities of Rukṣatā and Uṣṇatā while supporting Snigdhatā, Mṛdutva and Bala and providing Vāta–Rakta śamana. Rather than attempting to equate Sjögren’s syndrome directly with a single Ayurvedic disease entity, the treatment was individualized according to the patient’s clinical phenotype and Ayurvedic assessment.
Clinical Outcome
Following the intervention, improvement was observed in both objective inflammatory parameters and patient-reported clinical symptoms.
C-reactive protein decreased from 48 mg/L to 8 mg/L, while erythrocyte sedimentation rate decreased from 60 mm/hr to 12 mm/hr. These changes represented substantial reductions in the measured inflammatory markers during the observation period.
The Schirmer test value increased from 2 mm/5 min to 4 mm/5 min. This represented an increase in measured tear wetting from baseline. However, the post-treatment value remained low and therefore should be interpreted as partial improvement in the objective measure of tear secretion rather than normalization of lacrimal function.
The patient also reported subjective improvement in ocular dryness and oral dryness, along with reduction in joint pain and fatigue.
Conclusion
This case illustrates the potential utility of an Ayurvedic phenotype-based approach in a patient with Sjögren’s syndrome presenting with a Vātarakta-like inflammatory phenotype characterized by prominent Rukṣatā and Rakta involvement.
The therapeutic strategy focused on addressing the clinical manifestations of Rukṣatā and Uṣṇatā while simultaneously supporting Vāta–Rakta balance and systemic strength. Following the intervention, reductions in CRP and ESR were accompanied by improvement in sicca-related symptoms, joint pain, fatigue and the measured Schirmer test value.
Importantly, the improvement in Schirmer testing was partial, and the post-treatment value remained below the range generally considered indicative of normal tear secretion. Therefore, the findings should not be interpreted as evidence of complete restoration of lacrimal gland function.
As this is a single case report without a control group, the observed improvements cannot establish treatment efficacy, mechanism or causality. Spontaneous variation, concurrent factors and the natural course of the disease cannot be excluded. Nevertheless, the case provides a clinically relevant example of how Ayurvedic phenotype-based reasoning may be applied to a complex systemic autoimmune presentation for which there is no direct one-to-one classical Ayurvedic disease correspondence. Prospective studies using standardized clinical, laboratory and objective sicca assessments are required to further evaluate this therapeutic approach.
