NUMERO: #20240629

Título: SJÖGREN'S SYNDROME IN A YOUNG PATIENT: A POTENTIAL DIAGNOSTIC PITFALL

Nome do Apresentador: Pedro Franco FERREIRA

Categoria do Trabalho: Painel de caso clínico (PCC)

Área Temática: Estomatologia

Resumo: Sjögren's syndrome (SS) is an autoimmune disease often misdiagnosed due to its varied symptoms. A 27-year-old woman presented with neck pain and swelling, odynophagia, dysphagia, oral candidiasis episodes, weight loss and fever over two years. Physical examination revealed cervical, axillary and inguinal lymphadenopathy, submandibular glands enlargement, conjunctival erythema, dry lips and oral mucosa, and red/lobulated tongue. Initial diagnostic hypotheses were infectious, neoplastic and autoimmune diseases. Complementary investigation included blood count, acute-phase proteins, serology (VDRL, HIV, HBV, HCV, HAV, EBV), autoantibody research, cervical ultrasound, cervical node and labial minor salivary gland biopsies, unstimulated whole salivary flow test (UWSF), and ophthalmologic examination. Primary SS was confirmed based on the presence of dry eyes and mouth, hyposalivation (UWSF=0.08mL/min), Schirmer's test (right eye=3mm/left eye=5mm), focal lymphocytic sialadenitis (focus score >1) and anti-SSA/Ro antibody (59.6U/mL). Treatment involved nystatin suspension for oral candidiasis, prednisone and hydroxychloroquine. Sixteen months post-diagnosis, the patient remains stable under outpatient care.

Autor 1:  Pedro Franco FERREIRA

E-mail 1:  [email protected]

Autor 2:   Leticia Rodrigues CASTRO

E-mail 2:  [email protected]

Autor 3 :  Fabiola Reis de OLIVEIRA

E-mail 3:  [email protected]

Autor 4:  Fernando CHAHUD

E-mail 4:  [email protected]

Autor 5:  Eduardo Melani ROCHA

E-mail 5:  [email protected]

Autor 6:  Ana Carolina Fragoso MOTTA

E-mail 6:  [email protected]