Pathology · patient case question
Which finding would you NOT expect in this patient?
Patient case: Sjögren Syndrome and Blood Pressure Screening
demo: 56-year-old female
chief: “My mouth and eyes are constantly dry.”
history: Rheumatoid arthritis. Positive anti-SSA (Ro) and anti-SSB (La) antibodies.
meds: Hydroxychloroquine
findings: Blood pressure 145/92 mmHg on two readings. Dry, atrophic oral mucosa with a lobulated tongue, generalized gingival recession, marginal gingivitis, and rampant cervical caries. Bilateral parotid enlargement. Extensive interproximal staining.
Show answer and explanation
Correct answer: C. Multiple oral ulcerations
- A. Recession follows from the associated periodontal disease and mucosal atrophy.
- B. Gingivitis is common because reduced salivary flow impairs plaque clearance and buffering.
- C. Correct — this is the exception. Sjögren syndrome causes dryness, atrophy, and secondary infection; frank ulceration is not a characteristic feature. Recurrent oral ulcers would point toward Behçet disease or an autoimmune blistering disorder instead.
- D. Xerostomia is the cardinal oral feature, arising from lymphocytic destruction of the salivary parenchyma.