All the following features are found in Sjogren syndrome, EXCEPT:
Correct Answer: Granulomas in salivary glands
Description: Sjogren's syndrome is a chronic, slowly progressive autoimmune disease characterized by lymphocytic infiltration of the exocrine glands resulting in xerostomia and dry eyes. The prevalence of primary Sjogren's syndrome is approximately 0.5-1%, while 30% of patients with autoimmune rheumatic diseases suffer from secondary Sjogren's syndrome The majority of Sjogren's syndrome patients have symptoms related to diminished lacrimal and salivary gland function. The principal oral symptom of Sjogren's syndrome is dryness (xerostomia). Ocular involvement is the other major manifestation of Sjogren's syndrome. Lymphoma is a well-known manifestation of Sjogren's syndrome that usually presents later in the illness. Persistent parotid gland enlargement, purpura, leukopenia, cryoglobulinemia, and low C4 complement levels are manifestations suggesting the development of lymphoma. Most lymphomas are extranodal, low-grade marginal zone B cell lymphomas and are usually detected incidentally upon evaluating the labial biopsy. Granulomas in salivary glands is seen in sarcoidosis. Ref: Moutsopoulos H.M., Tzioufas A.G. (2012). Chapter 324. Sjogren's Syndrome. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
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