Pathology · patient case question
What is the diagnosis?
Patient case: Case: decreased saliva and decreased tears
Scenario: A patient presents with reduced salivary flow and reduced tear secretion.
Show answer and explanation
Correct answer: B. Sjögren syndrome
- A. Lupus is characterised by a malar butterfly rash, photosensitivity, arthritis and renal involvement; sicca symptoms occur only when Sjögren coexists.
- B. Correct. The combination of xerostomia and keratoconjunctivitis sicca is the defining sicca complex of Sjögren syndrome, an autoimmune exocrinopathy with anti-SSA (Ro) and anti-SSB (La) antibodies.
- C. Rheumatoid arthritis alone affects joints. When it accompanies sicca symptoms, the diagnosis is secondary Sjögren syndrome.
- D. Sarcoidosis can enlarge the salivary glands (Heerfordt syndrome) but is a granulomatous disease with hilar lymphadenopathy, not a primary sicca syndrome.