Mikulicz syndrome, an uncommon entity in Pakistan

A 38 years old woman presented with bilaterally symmetrical, painless swelling of the parotid, submandibular and sublingual glands. A fine needle aspiration biopsy revealed granulomatous histology with a few salivary ductal structures. On the basis of the histology, she was started on antituberculosis regimen until about 6 weeks later when she developed a skin rash on her shins, diagnosed as erythema nodosum co-existent with xerostomia. Her ESR was 38 mm and Mantoux test was negative. There was no lacrymal gland swelling and corneal tear film was normal on slit lamp examination. A diagnosis of sarcoidosis affecting the major salivary glands was made. The salivary glandular swelling, subsided within two weeks of treatment with oral prednisolone.