Primary Sjogren's syndrome and rampant dental caries in a 5-year-old child

A 5-year-old boy of Pakistani parents first presented with rampant dental caries and later developed bilateral parotid gland enlargement accompanied by intermittent nocturnal fever, anorexia, lethargy and weight loss. Investigations revealed anaemia, hypergammaglobulinaemia, elevated non-specific indices of inflammation, a reduced Schirmer's test value, lymphocytic infiltration and some atrophy of the parotid gland. The parotid gland enlargement, low Schirmer's test value and salivary gland biopsy showing non-focal lymphocytic infiltration led to the diagnosis of primary Sjogren's syndrome. The present case report highlights the need for health professionals to be aware that Sjogren's syndrome is a possible, if rare, predisposing cause of rampant dental caries in children.