A Case of Pediatric Sjögren's Syndrome Diagnosed With Microcalcifications in Both Parotid Glands

Sjögren's syndrome (SS), an autoimmune disease primarily affecting the exocrine glands, particularly the lacrimal and salivary glands, typically manifests as sicca symptoms (dry mouth and dry eyes). However, these symptoms are uncommon in pediatric patients. We present a case of a 13-year-old boy diagnosed with SS following the detection of bilateral parotid gland microcalcifications during a computed tomography scan for headache evaluation. The patient presented with a chief complaint of persistent headaches and malaise. However, he did not have sicca symptoms. A plain head computed tomography scan revealed multiple microcalcifications within the bilateral parotid glands. The fat-suppressed T2-weighted magnetic resonance imaging scan showed bilateral parotid gland enlargement and scattered areas of high intensity within the parotid glands. The patient was diagnosed with SS based on a serological examination and salivary and lacrimal gland disorders. Treatment with hydroxychloroquine improved headache and fatigue substantially. The patient can now participate in sports and daily life activities without difficulty. These findings stress the importance of considering SS in the differential diagnosis of children with chronic headaches and malaise. The presence of calcification within the parotid gland should raise suspicion for SS, and imaging studies can be a valuable tool for diagnosis, providing crucial information for informed decision-making.