Sjögren’s Before Sjögren: Did Henrik Sjögren (1899–1986) Really Discover Sjögren’s Disease?

The idiom Sjögren’s disease was named after Henrik Sjögren (1899–1986) a Swedish ophthalmologist who was the first person identified a group of women and correlated the triad of keratoconjuctiva sicca, xerostomia and polyarthritis [1]. He graduated in Medicine in 1918 from Karolinska Institute and qualified as a physician in 1927. His keen passion for ophthalmology was expressed as early as 1925 where he identified the first patient’s classical symptoms which were to bear his name and whose name bears the eponym. His further commitment to ophthalmology led him to establish the first ophthalmology department in a Swedish town where he developed his interest in corneal grafting.

Historical traces of Sjögren’s disease can be linked to documented historical records which show that these symptoms of what we now know as Sjögren’s disease were reported by physicians prior to Henrik Sjögren. In 1871 the first reported case of dry eyes and dry mouth illustrated by both W.B. Hadden and J.W. Hutchinson.

Sjögren’s syndrome is also synonymous with sicca complex syndrome and Mikulicz’s disease. Sicca is a Latin word defined as dryness and was used in conjunction with keratoconjunctivitis to coin the term keratoconjunctivitis sicca defining the dryness of the cornea and conjunctiva The triad manifestation of Sjögren’s disease is also known as the sicca complex.

Mikulicz disease derived its term in 1888, by Johann von Mikulicz–Radecki which is used under the subset of Sjögren’s disease and demonstrates the enlargement of the parotid, submandibular and lacrimal glands.

Further reports of these classical symptoms were also recognized in 1925 by a Frenchman by the name Gougerot’s syndrome which also related the three classical symptoms of dry mouth, dry eyes and polyarthritis.

When Henrik Sjögren initially published his work, this was unnoticed and he was not given the title of docent and his academic role as an ophthalmologist was hindered.

In 1943 his work was later published in English and at this time he was given recognition for his work and was awarded a post as an associate professor at the University of Gotenberg and in 1961 was attributed with the title of honorary professor.

In 1953 the correlation between Sjögren’s disease and lymphoproliferative diseases was linked by the English physician Morgan. These studies have shown that histologically both Sjögren’s disease and Mukulicz disease were analogous and subsequently no more cases of Mukulicz disease have been reported and the term has become obsolete.

Not only was Henrik Sjögren the first person to correlate the triad of keratoconjuctiva sicca, xerostomia and polyarthritis but he provided the seal for the definition of this condition by his eponym and the name of all his predecessors became superseded.

Henrik Sjögren died on the 17th September 1986. His expertise not only led to the defining of Sjögren disease but he was also the first person to develop the recognition of corneal grafting. He amalgamated his expertise in several specialties for which he was given an honorary position in the ophthalmological society of Australia and American rheumatism board. He was also recognized by the Royal college of Physicians and Surgeons in Glasgow for his commitment to Medicine and Surgery.