The Differential Diagnosis of Dry Eyes, Dry Mouth ...

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The Differential Diagnosis of Dry Eyes, Dry Mouth, and Parotidomegaly: A Comprehensive Review. Divi Cornec & Alain Saraux & Sandrine Jousse-Joulin ...

Clinic Rev Allerg Immunol DOI 10.1007/s12016-014-8431-1

The Differential Diagnosis of Dry Eyes, Dry Mouth, and Parotidomegaly: A Comprehensive Review Divi Cornec & Alain Saraux & Sandrine Jousse-Joulin & Jacques-Olivier Pers & Sylvie Boisramé-Gastrin & Yves Renaudineau & Yves Gauvin & Anne-Marie Roguedas-Contios & Steeve Genestet & Myriam Chastaing & Béatrice Cochener & Valérie Devauchelle-Pensec

# Springer Science+Business Media New York 2014

Abstract Primary Sjögren’s syndrome (pSS) is a frequent autoimmune systemic disease, clinically characterized by eyes and mouth dryness in all patients, salivary gland swelling or extraglandular systemic manifestations in half of the patients, and development of lymphoma in 5 to 10 % of the patients. However, patients presenting with sicca symptoms or salivary gland swelling may have a variety of conditions that may require very different investigations, treatments, or followup. Eye and/or mouth dryness is a frequent complaint in clinical setting, and its frequency increases with age. When evaluating a patient with suspected pSS, the first step is to rule out its differential diagnoses, before looking for positive

arguments for the disease. Knowledge of normal and abnormal lachrymal and salivary gland physiology allows the clinician to prescribe the most adapted procedures for evaluating their function and structure. New tests have been developed in recent years for evaluating these patients, notably new ocular surface staining scores or salivary gland ultrasonography. We describe the different diagnoses performed in our monocentric cohort of 240 patients with suspected pSS. The most frequent diagnoses are pSS, other systemic autoimmune diseases, idiopathic sicca syndrome and drug-induced sicca syndrome. However, other diseases are important to rule out due to their specific management, such as sarcoidosis, granulomatosis

Highlights Sicca complaints are very common and several tests are required to perform a diagnosis. Viral infections connective tissue diseases, sarcoidosis, drugs may induce sicca symptoms. The most frequent differential diagnosis of Sjögren’s syndrome is idiopathic sicca syndrome. D. Cornec : A. Saraux : S. Jousse-Joulin : V. Devauchelle-Pensec Department of Rheumatology, Brest Teaching Hospital, Brest, France


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