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Case report
Primary Sjogren’s syndrome: a great masquerader
  1. Naveen Kumar1,
  2. Deepanjali Surendran1,
  3. Bheemanathi Hanuman Srinivas2 and
  4. Chanaveerappa Bammigatti1
  1. 1Medicine, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, Puducherry, India
  2. 2Pathology, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India
  1. Correspondence to Dr Chanaveerappa Bammigatti; bammigatti{at}yahoo.com

Abstract

A 41-year-old woman presented with paresthesia and inability to walk for 7 days. She had history of fatigue, polyarthralgia and difficulty in swallowing food for the last 1 year. She became edentulous over the last 5 years and wore dentures for the same. She appeared pale, emaciated and had oral thrush. She had areflexic quadriparesis with weakness more in lower limbs compared with upper limbs. With the initial diagnosis of Guillian-Barre syndrome, she was given five cycles of plasmapheresis following which there was a significant improvement in power. Sjogren’s syndrome was suspected based on edentulous state in a middle-aged woman with multisystem involvement. Evaluation with Schirmer’s test, parotid scintigraphy and labial minor salivary gland biopsy confirmed the diagnosis. She was treated with steroids following which a dramatic improvement in haemoglobin and total leucocyte count was noted. We report a varied presentation of primary Sjogren’s syndrome.

  • dentistry and oral medicine
  • peripheral nerve disease
  • Sjogren's syndrome
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Footnotes

  • Contributors NK was responsible for management of the patient and manuscript preparation. DS was involved in patient management and manuscript preparation. BHS was involved in patient management and manuscript preparation. CB was responsible for management of patient and manuscript preparation and is following up the patient currently.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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