1/13. A primary sjogren's syndrome patient with distal renal tubular acidosis, who presented with symptoms of hypokalemic periodic paralysis: Report of a case study and review of the literature.Although renal tubular acidosis (RTA), secondary to autoimmune interstitial nephritis, develops in a large proportion of patients with sjogren's syndrome (SS), most of the subjects are asymptomatic. Here, we shall present a 39-year-old female patient who came to us with hypokalemic periodic paralysis (HPP), and who was later diagnosed with distal RTA. The patient, who had xerostomia and xerophthalmia for a long period of time, was diagnosed with primary SS from serologic and histologic findings. The patient recovered by being prescribed potassium replacement therapy. Although renal biopsy was not performed, corticosteroids were administered because HPP indicated severe interstitial nephritis. HPP did not reoccur during a 2-year follow-up period. We also review cases with SS-related distal RTA and HPP.- - - - - - - - - - ranking = 1keywords = xerostomia (Clic here for more details about this article) |
2/13. Subacute aseptic meningitis as neurological manifestation of primary sjogren's syndrome.sjogren's syndrome (SS) is an autoimmune disease characterized by inflammatory infiltration and secondary chronic dysfunction of exocrine glands. Systemic (extraglandular) manifestations of the disease occur in one-third of the patients, including a wide spectrum of peripheral and central neurological disorders. We report a case of subacute afebrile aseptic meningitis (AM) as neurological manifestation of primary SS. The neurological symptomatology presented gradual onset and progression, including diplopia, mild headache, pain and stiffness of the neck. The clinical examination pointed out xerostomia and xerophthalmia. diagnosis of SS was confirmed by Schirmer's tear test and histopathology of the labial salivary glands. The neurological involvement was highlighted by gadolinium-enhanced magnetic resonance imaging of the brain which displayed an increased diffuse leptomeningeal enhancement. cerebrospinal fluid (CSF) analysis showed moderate pleocytosis with prevalence of polymorphonuclear leukocytes and increased protein level but no evidence of Ig intrathecal synthesis. A cycle of intravenous steroid therapy led to a complete disappearance of the neurological symptomatology and to normalization of the CSF inflammatory pattern. Given the unusual presentation of this case of AM, which resembled the characteristics of a chronic meningitis rather than those of an acute form, in patients affected by SS we must stress the importance of cephalic symptoms such as headaches and cervical stiffness (even if mild and without fever) as possible signs of central neurological involvement of the disease.- - - - - - - - - - ranking = 1keywords = xerostomia (Clic here for more details about this article) |
3/13. diagnosis of systemic sarcoidosis prompted by orofacial manifestations: a review of the literature.BACKGROUND: sarcoidosis is a multifactorial systemic inflammatory disorder of unknown origin characterized by many potential signs and symptoms, as well as by the presence of noncaseating granulomas in the organs involved. sarcoidosis also may manifest in the oral and maxillofacial region. CASE DESCRIPTION: The authors describe a patient with xerostomia, dysgeusia, oral burning, xerophthalmia and bilateral parotid enlargement. She was diagnosed as having systemic sarcoidosis on the basis of the histologic findings of a biopsy of the labial minor salivary gland, as well as subsequent diagnostic evalutons. CONCLUSION AND CLINICAL IMPLICATIONS: Enlargement of major salivary glands may be the first sign of sarcoidosis in a patient with few other symptoms or clinical findings suggestive of the disease. This case emphasizes the importance of including sarcoidosis in the differential diagnosis of bilateral parotid swelling associated with xerostomia. It also highlights the dentist's potential role in the diagnosis and dental treatment of patients with systemic sarcoidosis.- - - - - - - - - - ranking = 2keywords = xerostomia (Clic here for more details about this article) |
4/13. xerophthalmia secondary to alcohol-induced malnutrition.BACKGROUND: xerophthalmia refers to the ocular manifestations associated with vitamin a deficiency. vitamin a deficiency can be caused by numerous disorders, including alcohol-induced malnutrition. The ocular manifestations of xerophthalmia include conjunctival and corneal xerosis (drying), keratomalacia (corneal necrosis/ulceration), nyctalopia (night blindness), and Bitot's spots (conjunctival lesions). CASE REPORT: A 47-year-old white male with complaints of dryness and difficulty seeing at night presented to our clinic for consultation from general medicine to rule out xerophthalmia. Laboratory testing and general medicine, psychiatry, and nutrition evaluations confirmed the systemic diagnosis of alcohol-induced malnutrition. He admits that his alcoholism was induced by depression. Confirmed associated disorders compounding the malnutrition include alcoholic cirrhosis, protein deficiency, and megaloblastic anemia. The patient had xerophthalmia diagnosed in the optometry clinic as a result of symptoms, slit lamp examination signs, and the associated disorders. The associated disorders were treated with systemic medications and vitamins. Ophthalmic treatment consisted of carboxymethylcellulose-based artificial tears. CONCLUSIONS: Although xerophthalmia and vitamin a deficiency are more common in underdeveloped countries, their presentation in the united states may be induced by conditions such as liver cirrhosis, malnutrition, and alcoholism. This report summarizes ocular manifestations of alcoholism and presents a case of xerophthalmia secondary to alcohol-induced malnutrition and the role of optometry in its treatment and management.- - - - - - - - - - ranking = 0.44019278186135keywords = dryness (Clic here for more details about this article) |
5/13. Sjogren-like pluriglandular exocrine insufficiency after drug-induced toxic epidermal necrolysis.We present the case of a patient that progressively developed xerophthalmia, xerostomia, cutaneous xerosis and exocrine pancreatic insufficiency 3 months after metamizole-induced toxic epidermal necrolysis. Though the association of sjogren's syndrome and exocrine pancreatic impairment is well established, the Sjogren-like syndrome after drug-induced toxic epidermal necrolysis in association with such a wide exocrine glandular insufficiency has not been previously described, to our knowledge.- - - - - - - - - - ranking = 1keywords = xerostomia (Clic here for more details about this article) |
6/13. A diffuse infiltrative CD8 lymphocytosis syndrome in human immunodeficiency virus (hiv) infection: a host immune response associated with HLA-DR5.STUDY OBJECTIVE: To describe the clinical, immunologic, and immunogenetic features of a diffuse infiltrative lymphocytic disorder resembling Sjogren syndrome in persons infected with human immunodeficiency virus (hiv). DESIGN: Clinical case study. SETTING: University-affiliated hospitals and outpatient clinics. patients: Consecutive sample of 17 patients. MEASUREMENTS AND MAIN RESULTS: All of the 17 patients had bilateral parotid gland enlargement; 14 had xerostomia and 6 had xerophthalmia. Of the 17 patients, 14 had generalized lymphadenopathy, 10 had histologically proved lymphocytic interstitial pneumonitis, 4 had neurologic involvement, and 3 had lymphocytic infiltration of the gastrointestinal tract. gallium scanning in all of 11 tested patients showed abnormal salivary gland uptake. Minor salivary gland biopsies showed more than 2 lymphocytic foci per 4 mm2 tissue in all of 11 tested patients, the infiltrate consisting predominantly of CD8 cells. Fifteen patients had circulating CD8 lymphocytosis; the principal phenotype of these cells was CD8 CD29 . Rheumatoid factor and antinuclear antibodies were infrequent, and none of the patients had anti-Ro/SS-A or anti-La/SS-B antibodies. HLA-DR5 was significantly more frequent in the black patients (10 of 12) compared with controls (13 of 45). Only one patient developed an opportunistic infection during 544 patient-months of study, and none has died of AIDS. CONCLUSIONS: A distinct syndrome primarily characterized by parotid gland enlargement, sicca symptoms, and pulmonary involvement occurs in hiv infection. This disorder is associated with CD8 lymphocytosis and the presence of HLA-DR5, and appears to be a genetically determined host immune response to hiv.- - - - - - - - - - ranking = 1keywords = xerostomia (Clic here for more details about this article) |
7/13. Microvascular submandibular gland transfer; an alternative approach for total xerophthalmia.A case of total xerophthalmia is reported in which microvascular transfer of the submandibular gland relieved the dryness with negligible side-effects.- - - - - - - - - - ranking = 0.44019278186135keywords = dryness (Clic here for more details about this article) |
8/13. Sicca symptom in a patient with hemochromatosis: minor salivary gland biopsy for differential diagnosis.This paper reports a case of hemochromatosis with sicca symptom. The patient was a 59-year-old female who had been received a series of intravenous iron injections and blood transfusions because of anemia owing to side-effects of a chemotherapeutic agent. She complained of dry mouth and dry eyes in addition to symptoms of hemochromatosis. The histological appearance of the labial salivary gland, with heavy deposition of iron in acinar and duct epithelial cells and absence of focal lymphoid cell infiltration, did not support a diagnosis of sjogren's syndrome but suggested functional damage of the salivary glands related to iron. The patient was given desferrioxamine, and clinical symptoms improved; re-examined labial salivary gland biopsy showed no iron deposition in any parenchymal cells after the treatment.- - - - - - - - - - ranking = 2.8506953135364E-5keywords = mouth (Clic here for more details about this article) |
9/13. Ocular reaction to timolol maleate.A patient prescribed timolol maleate for the control of hypertension developed dryness of the eyes. The symptoms improved on withdrawal of the drug. Vigilance for such adverse reactions must be observed in the use of any beta-adrenoreceptor blocking agent.- - - - - - - - - - ranking = 0.44019278186135keywords = dryness (Clic here for more details about this article) |
10/13. Specific xerostomia during Urbach-Wiethe disease.We describe the case of a 59-year-old woman who had suffered from a typical Urbach-Wiethe disease since childhood and who complains of progressive mouth and ocular dryness since the age of 54 years. xerostomia was severe with very poor salivation and was associated with a slight keratoconjunctivitis sicca. A specific lipoid proteinosis was evidenced in salivary glands (lower lip biopsy) with a PAS-positive hyalin-like deposit around vessels, capillaries and salivary gland canaliculi. An ultrastructural study showed the typical aspect of multilamination of the basal lamina of capillary vessels. dysphonia and hoarseness are commonly found in Urbach-Wiethe disease, but, to our knowledge, a specific xerostomia has never been reported.- - - - - - - - - - ranking = 5.4402212888145keywords = xerostomia, dryness, mouth (Clic here for more details about this article) |
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