Case Summary
Ms. Charles is a female who presented with a gradual onset of seemingly unrelated symptoms that progressively worsened throughout her life. As a child she developed multiple dental caries and periodontal disease. A few years later, she began having dry mouth symptoms; generalized myalgias and arthralgias; and chronic eye irritation and blepharitis, which did not respond to over-the-counter eye drops, allergy medications, or pain medications. She was evaluated by multiple physicians and was diagnosed as having ‘growing pains’ and ‘allergies.’ In her 20s, she began having, what’s perhaps her most debilitating symptoms, bouts of fatigue and depression, but due to the scattered and seemingly unrelated symptoms, physicians were unable to pinpoint the exact cause of all her symptoms. For many years she dealt with these debilitating symptoms, and a number of other painful setbacks, including severe acid reflux, a perforated gallbladder due to bile stasis, and a corneal ulcer. Frustrated, she sought the care of Dr. Laibson, an ophthalmologist at the Wills Eye Hospital in Philadelphia, who suspected something more serious than just ‘dry eyes’ was going on. He performed multiple tests, …show more content…
Primary SS occurs as an isolated disorder, while secondary SS occurs in connection with another autoimmune disease. Of these, rheumatoid arthritis is the most common, but some patients may have SLE, polymyositis, scleroderma, vasculitis, mixed connective tissue disease, or thyroiditis, and because of this overlap with many other rheumatic disorders, it is sometimes difficult to determine whether a clinical manifestation is solely a consequence of Sjögren’s or another
Ms. Charles is a female who presented with a gradual onset of seemingly unrelated symptoms that progressively worsened throughout her life. As a child she developed multiple dental caries and periodontal disease. A few years later, she began having dry mouth symptoms; generalized myalgias and arthralgias; and chronic eye irritation and blepharitis, which did not respond to over-the-counter eye drops, allergy medications, or pain medications. She was evaluated by multiple physicians and was diagnosed as having ‘growing pains’ and ‘allergies.’ In her 20s, she began having, what’s perhaps her most debilitating symptoms, bouts of fatigue and depression, but due to the scattered and seemingly unrelated symptoms, physicians were unable to pinpoint the exact cause of all her symptoms. For many years she dealt with these debilitating symptoms, and a number of other painful setbacks, including severe acid reflux, a perforated gallbladder due to bile stasis, and a corneal ulcer. Frustrated, she sought the care of Dr. Laibson, an ophthalmologist at the Wills Eye Hospital in Philadelphia, who suspected something more serious than just ‘dry eyes’ was going on. He performed multiple tests, …show more content…
Primary SS occurs as an isolated disorder, while secondary SS occurs in connection with another autoimmune disease. Of these, rheumatoid arthritis is the most common, but some patients may have SLE, polymyositis, scleroderma, vasculitis, mixed connective tissue disease, or thyroiditis, and because of this overlap with many other rheumatic disorders, it is sometimes difficult to determine whether a clinical manifestation is solely a consequence of Sjögren’s or another