Sjögren syndrome hidden by previous parotidectomy and cervicofacial radiotherapy

Abstract

Introduction: Sjögren’s syndrome (SS) is a chronic inflammatory auto-immune disease of the exocrine glands which incidence increases with age. Sex ratio is 9.9 female for 1 male. Observation: A 67-year-old female patient presented for xerostomia leading to major functional impairment. The medical history of the patient was pulmonary sarcoidosis, with join and adenoid involvement, considered as cured; left partial parotidectomy, with a diagnosis of acinous carcinoma, followed 7 years later by a total parotidectomy due to tumor recurrence, and followed by external radiotherapy (70 Gy). Arterial hypertension, hypothyroïditis and diabetes mellitus were also noticed. She reported xerostomia and xerophtalmia. Seric anti-SSA antibodies were positive and histologic findings were compatible with SS. Commentaries: Despite other co-morbidities, the diagnosis was hidden by previous parotidectomy and cervical radiotherapy. Thus, SS should not be underdiagnosed in patients with complex medical history.

Keywords

• syndrome
• sjögren
• xerostomy