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Case Reports
. 2024 Sep 4;19(11):5513-5518.
doi: 10.1016/j.radcr.2024.07.196. eCollection 2024 Nov.

Secondary Sjögren's syndrome in a rheumatoid arthritis patient: A case report and review of literature

Abdulaziz Hussein  1 , Awadia Gareeballah  2   3 , Zuhal Y Hamd  4 , Maisa Elzaki  2   3 , Raga Ahmed Abouraida  5 , Mohamed Abdalla Eltahir  6 , Mariam Khogaly  7 , Walaa Alsharif  2 , Ali A Hamad  8
Affiliations
Case Reports

Secondary Sjögren's syndrome in a rheumatoid arthritis patient: A case report and review of literature

Abdulaziz Hussein et al. Radiol Case Rep. .

Abstract

Secondary Sjogren's syndrome (sSS) is a medical condition that occurs in individuals with autoimmune diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis. It predominantly affects females rather than males. We present a case of a 32-year-old female with a 3-year history of rheumatoid arthritis (RA) who presented to the internal medicine and rheumatology clinic with several complaints, including swelling and tenderness in her left jaw, dry mouth (xerostomia), irritated eyes (xerophthalmia), severe joint pain, and a decreased in saliva production. The blood tests demonstrate the presence of anti-SSA and anti-SSB autoantibodies and elevation of total leukocyte count (TLC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels, indicating inflammation. A high-frequency ultrasound confirmed the diagnosis of Secondary Sjogren's syndrome grade II, specifically affecting the left parotid gland (PG).

Keywords: Rheumatoid arthritis; Salivary glands; Sjögren's syndrome; Sonographic findings.

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Figures

Fig 1
Fig. 1
(A and B) US images show normal both thyroid lobes and right PG (R.PG) display homogenous echotexture and normal echogenicity. (C) Shows inhomogeneous left PG occupying unnamable hypoechoic areas and hyperechoic lymphocytic infiltration of sSS. Look at the heterogeneity of left PG compared to the R.PG (R.TH: right thyroid lobe, L.TH: left thyroid lobe, SHM: sternohyoid muscle, and STM: sternothyroid muscle).
Fig 2
Fig. 2
(A) US image of left SAG PG involvement of a patient with SS shows an enlarged gland that is diffusely heterogeneous in texture with a smooth outer surface and decreases in echogenicity, multiple millimetric-nodular *hypoechoic areas within for (Grade 2 of sSS). (arrow) indicted for the posterior shadowing echo from the mastoid bone. (B) Transverse image of left PG whereas the (arrows) represent the lymphocytic infiltration depositions areas within the affected parotid parenchyma. (S: skin).
Fig 3
Fig. 3
US image of color Doppler shows reduced vasculature within heterogeneous parotid parenchyma of a patient with sSS.
See this image and copyright information in PMC

References

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