Dry syndrome is a relatively common rheumatic immune disease. If it is not treated in time, it will lead to damage to many systems such as immune, respiratory, digestive, cardiovascular, urinary and nervous system, which will affect the quality of life in mild cases and can be life-threatening in serious cases. So, what conditions should we be alert to dry syndrome? Let’s see what typical clinical symptoms it has? (A) Oral manifestation About 80% of dry syndrome has the manifestation of dry mouth. Most of the patients have reduced saliva secretion, often carry a water cup with them, and like to drink water frequently when they speak. They often get up at night to drink water to quench their thirst or wake up dry from a deep sleep. Forty percent of patients have recurrent and alternating bilateral or unilateral enlargement of the parotid glands, which is often referred to as “big mouth”. In some cases, mouth ulcers and oral bleeding may occur. The tongue is also not immune to damage, with a dry, cracked tongue with beef-like lines, or a smooth, dark red tongue, or a painful, ulcerated tongue. Another important manifestation is the change of teeth. 50% of the patients show rampant caries, which means there are large rotten teeth in a short period of time, and only some residual roots are left in the teeth. This manifestation is very helpful for the diagnosis of dry syndrome – if rampant caries is present, the diagnosis is almost confirmed. All these changes are caused by the invasion of salivary glands by the “desert” of dry syndrome, resulting in the decrease of salivary gland secretion and dry mouth, which is one of the important clinical manifestations of dry syndrome. (2) Eye manifestations Besides salivary gland, dry syndrome will also encroach on tear gland, resulting in reduced tear secretion. Some patients may feel that their eyes are very dry, as if they have been surfing the Internet for a long time or watching several movies in a row, so they often carry eye drops with them at all times and apply one or two drops from time to time to moisten their eyes. Some of them may have symptoms such as not being able to open their eyes in the morning after waking up, having a lot of eye droppings, painful eyes and photophobia. Some patients may feel grit in their eyes and have a foreign body sensation, but they are treated as trachoma for a long time. In severe cases, ocular diseases such as conjunctival crinkle, corneal ulceration and perforation, uveal ulceration, cataract, glaucoma, and enlarged tear glands can occur. In some cases, it can cause a poor response to chemical or emotional stimuli, which is often referred to as “no tears” – whether happy or sad, no tears can come out of the eyes. Many patients are often delighted to find that they can shed tears again after the disease is in remission, which can be called “tears of joy”. These are the clinical manifestations of dry syndrome invading the lacrimal gland. (3) Joint manifestations In addition to dry mouth and dry eyes, many patients with dry syndrome also have joint pain. It may occur repeatedly. The pain sites are usually large joints, such as shoulder joints, elbow joints, knee joints, etc., mostly asymmetrical, and sometimes smaller joints, such as finger joints, toe joints, etc., may also have pain. It usually does not cause permanent joint damage and rarely causes joint deformation. Therefore, those who have dry mouth, dry eyes and unexplained joint pain should be alert and go to the rheumatology department of a regular hospital as soon as possible, so that a specialist can determine whether they are suffering from dry syndrome.