A 62-year-old woman with Sjogren syndrome presented with a clinical history similar to that of patient 1 and with similar findings on serology and a lip biopsy.
In 1998, Izumi et al reported that steroid irrigation of the parotid gland significantly increased salivary flow rate inpatients with Sjogren syndrome.
6) We propose that Sjogren syndrome can be treated not only with intraductal steroid infusions, but also with other disease-modifying agents.
Sjogren syndrome was more prevalent in group I [42 (45%) of 93 patients] than in group II [10 (18%) of 56 patients; [[chi].
In addition, group I included mainly patients with Sjogren syndrome and systemic lupus erythematosus, whereas group III contained patients with mixed connective tissue disease and systemic lupus erythematosus.
This conjecture is backed by earlier investigations that found distinct differences in the epitopes bound by sera from patients with systemic lupus erythematosus vs sera from patients with primary Sjogren syndrome [for a review, see Ref.
Given the laboratory and biopsy findings, a diagnosis of Sjogren syndrome was made.
The differential diagnosis of a submandibular mass includes a wide variety of conditions, including sialolithiasis, metastatic or primary malignancy, sarcoidosis, HIV infection, bacterial infection, hypertrophy related to underlying diabetes mellitus or vitamin deficiencies, and Sjogren syndrome.
Primary Sjogren syndrome was tentatively diagnosed after the exclusion of secondary causes by detailed physical examination (no joint deformity, skin rash or taut skin), laboratory studies (normal liver enzymes, thyroid function and negative viral markers of hepatitis B and C, EBV, and HIV), and immunologic examinations (negative anti-dsDNA, anti-histone, anti-SM/RNP, anti-neutrophil cytoplasmic antibodies and anti-mitochondrial antibody).
During a 1-year follow-up, he also had development of sicca syndrome and positive Schirmer test without evidence of other autoimmune disease and was diagnosed to have primary Sjogren syndrome.