Just Another Case of Sjögren’s Syndrome?

Abstract

To the Editor: A 60-year-old woman was seen at the outpatient clinic of the Department of Rheumatology because of increased complaints of xerophthalmia. In 1997, she had already been diagnosed with Sjogren’s syndrome (SS) based on xerophthalmia, xerostomia, bilateral salivary gland swelling, and positive sialography showing chronic inflammation without local obstruction. Antinuclear antibodies (ANA) and anti-SSA/SSB were negative. Because of persistent progressive salivary gland swelling at that time, a total bilateral submandibular gland excision was performed as development of non-Hodgkin lymphoma as a complication of SS was suspected. Histology showed sialoadenitis as seen in SS without signs of lymphoma. In 2002, a renal biopsy performed because of increased creatinine level without proteinuria revealed focal global glomerulosclerosis with interstitial nephritis due to SS or chronic ischemia. In an attempt to treat possible active interstitial nephritis due to SS, she was treated with 30 mg of prednisone and azathioprine. Prednisone was stopped after 6 months and azathioprine after one year, however, there was no …