Connective tissue diseases – assessment for Sjögren’s syndrome, lupus and scleroderma at Charlottenlund Privathospital

What is connective tissue disease?



Connective tissue is found throughout the body—in joints, tendons, skin, glands, blood vessels and organs. In an autoimmune connective tissue disease, the immune system produces antibodies against the body’s own cells, so inflammation can affect many areas at once. This explains why one disease can cause joint pain, rashes, dry eyes, fatigue and kidney or lung involvement. These diseases are chronic, but for most people the course is mild to moderate and can be monitored and treated.

According to the Danish Society for Rheumatology’s national treatment guidelines, lupus (SLE) affects around 90% women, typically of childbearing age, with a median age of 32 at first symptoms, and the prevalence in Denmark is approximately 45 per 100,000. According to the Society’s guidelines, Sjögren’s syndrome is also far more common in women, and 60–70% of patients have no internal organ involvement and follow a benign course, with symptoms mainly consisting of dryness, fatigue and pain.

What symptoms do connective tissue diseases cause?



Symptoms vary depending on the disease, but some features are common: pronounced fatigue, joint pain or swelling, rashes or sensitivity to sunlight, dry eyes and mouth, white, cold fingers in the cold (Raynaud’s phenomenon), mouth ulcers, hair loss and occasional low-grade fever. Many people experience symptoms for months or years before diagnosis, because each symptom on its own can have many other explanations.

Sjögren’s syndrome primarily causes dry eyes and mouth because it affects the tear and salivary glands. Symptoms include a gritty, burning sensation in the eyes, difficulty swallowing dry food, tooth decay and swollen salivary glands. Fatigue, joint pain and dry skin are common, and some people experience dizziness and tingling in their hands and feet. Lupus most often causes joint pain, a rash—classically across the cheeks and bridge of the nose—sensitivity to sunlight, mouth ulcers and fatigue; in some people, it affects the kidneys, blood, lungs or nervous system. Scleroderma typically begins with Raynaud’s phenomenon and thickened, tight skin on the fingers and hands, and can affect the oesophagus, lungs and kidneys.

What causes connective tissue diseases?

The cause is unknown. The diseases develop when an inherited predisposition combines with triggers—hormones, sunlight, infections, smoking or certain medicines—and the immune system begins to attack the body’s own tissue. Women are affected far more often than men, suggesting a role for sex hormones. The diseases are not contagious and are not directly inherited, but they occur more frequently in families with other autoimmune diseases.

How are connective tissue diseases assessed?

Assessment begins with a thorough medical history, in which the specialist systematically asks about symptoms affecting all organ systems—skin, mucous membranes, joints, eyes, mouth, lungs, kidneys and nervous system—and about autoimmune diseases in the family. The clinical examination covers the joints, skin, mucous membranes, salivary glands and blood vessels.

Blood tests are central to the assessment: antinuclear antibodies (ANA) are the screening test and, according to the current international lupus classification criteria (EULAR/ACR 2019), must be positive before lupus can be considered. Further tests then look for specific antibodies—including anti-dsDNA in lupus, anti-SSA and anti-SSB in Sjögren’s syndrome, and scleroderma-related antibodies—as well as markers of inflammation, blood count, kidney and liver function, and urine. If Sjögren’s syndrome is suspected, tear and saliva production are measured, and ultrasound scans of the salivary glands can support the diagnosis. If a tissue sample from the lip or skin, a lung examination or other imaging is needed, the specialist will refer you.

A positive ANA result does not in itself mean that you have connective tissue disease—the test is positive in some healthy people. Diagnosis is based on the overall picture, and that is often exactly what a rheumatology assessment clarifies: either a diagnosis with a plan, or a reasoned conclusion that the disease is not present.

How are connective tissue diseases treated?

Treatment depends on which organs are affected and how active the disease is. For Sjögren’s syndrome, treatment is mainly aimed at relieving symptoms: artificial tears and eye gel, oral care and saliva-stimulating products, regular dental check-ups and exercise, which has been shown to help with both pain and fatigue, according to Ugeskrift for Læger. Lupus and scleroderma are treated with medicines that reduce immune system activity, using a stepwise approach based on disease severity, alongside sun protection, smoking cessation and exercise. According to the lupus treatment guidelines, information about the disease, its course and treatment is a central part of care.

At Charlottenlund Privathospital, we provide assessment, diagnosis, initiation of outpatient treatment, as well as monitoring and advice. Connective tissue disease affecting the kidneys, lungs, heart or nervous system is treated in hospital; if the assessment shows that this is needed, you will be referred on with the completed assessment so your care can continue without delay.

Assessment for Sjögren’s syndrome is often carried out in collaboration with the hospital’s ENT specialists when the salivary glands, mucous membranes or dizziness are part of the picture.

When should I see a rheumatologist?

A rheumatology assessment is appropriate when symptoms affect several organ systems—for example, joint pain along with a rash, dry eyes and mouth along with fatigue, or Raynaud’s phenomenon along with tight fingers—and whenever your GP has found a positive ANA or other autoantibodies. It is also relevant for unexplained fatigue and joint pain in women of childbearing age, and when a known connective tissue disease needs reassessment.

Assessment and treatment at Charlottenlund Privathospital

Assessment is carried out by specialists in rheumatology on an outpatient basis. The initial consultation typically takes half an hour; blood tests and ultrasound scans can often be done the same day. Results and an overall assessment are provided at a follow-up consultation or by phone by agreement, and patients are followed by the same specialist.

Most patients come through health insurance; insurers typically require a GP referral and pre-approval before an appointment can be booked. No referral is needed if you are paying privately, and prices are listed in our price list. Appointments can be booked online around the clock or by phone on 44 98 19 21 Monday to Friday, 08:00–14:00. Outside phone hours, the digital phone assistant Anna can book, cancel and reschedule appointments. [Button: Book an appointment online → /online-booking]