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[Sjögren syndrome in ORL. Diagnostic considerations]
J J Leache Pueyo1, J Sevil Navarro, C Del Agua
1Servicios de O.R.L. y Anatomía Patológica, Hospital General Miguel Servet, Zaragoza.
Anales Otorrinolaringologicos Ibero-Americanos
|March 27, 2001
Summary
This case study highlights primary Sjögren's syndrome (PSS) diagnosis in a woman with dry eyes and mouth. Histopathology and immunochemical studies confirmed focal lymphocytic sialadenitis, aiding in diagnosis and differentiating from other prevalent conditions.
Area of Science:
- Immunology
- Rheumatology
- Ophthalmology
Background:
- Primary Sjögren's syndrome (PSS) is an autoimmune disorder affecting exocrine glands.
- Xerostomia (dry mouth) and keratoconjunctivitis sicca (KCS) are hallmark symptoms.
Observation:
- A 51-year-old woman presented with a 10-month history of xerostomia and KCS.
- Serum analysis revealed antibodies against SS-A (Ac anti-Ro/SS-A), antinuclear antibodies (ANAs), and rheumatoid factor (RF).
- Salivary gland function tests showed decreased radiotracer uptake and excretion.
Findings:
- Histopathology of minor salivary glands indicated focal lymphocytic sialadenitis (fsa).
- Immunohistochemistry revealed a predominance of CD4+ lymphocytes.
- These findings, combined with serological and functional tests, led to a diagnosis of PSS.
Implications:
- The study underscores the importance of integrating histopathological and immunochemical analyses with other diagnostic tests for PSS.
- Accurate diagnosis is crucial for differentiating PSS from other prevalent conditions like Hepatitis C (HCV) and Human Immunodeficiency Virus (HIV) infections.
- This approach aids in recognizing diverse clinical presentations of PSS and co-occurring pathologies.