Case 422 Enunciado A 42-year-old female seeks medical attention complaining of mouth dryness. Denies xerophthalmia, arthralgia, stiffness or joint swelling. Denies dermatological complaints or use of tricyclic antidepressants. In physical examination, it was noted dryness of the labial mucosa and atrophic and dry tongue, no other abnormalities. Laboratory exams showed positive ANA and anti-Ro/SS-A antibodies, only. Requested salivary glands scintigraphy. A 42-year-old female seeks medical attention complaining of mouth dryness. Denies xerophthalmia, arthralgia, stiffness or joint swelling. Denies dermatological complaints or use of tricyclic antidepressants. In physical examination, it was noted dryness of the labial mucosa and atrophic and dry tongue, no other abnormalities. Laboratory exams showed positive ANA and anti-Ro/SS-A antibodies, only. Requested salivary glands scintigraphy. Image 2: (A) Regions of interest (ROI) delimiting the glands. (B) Radioactive curves of activity X minutes before and after the administration of a small amount of acid substance (lemon juice). Question:In light of the patient’s clinical condition and of the scintigraphy image above, what is the main diagnostic hypothesis? Primary Sjögren’s Syndrome Systemic Lupus Erythematosus Warthin’s tumor Sialolothiasis Questão de Prova UFG - Medical Clinic test - 2009 In primary Sjögren’s Syndrome, the following laboratory changes are described: Na síndrome de Sjögren primária, as seguintes alterações laboratoriais são descritas: positive anti-Ro and anti-Sm positive anti-RNP and anti-La anemia and platelets increase polyclonal increase of gamma globulin and positive rheumatoid factor Time is Up! Time's up
