Abstract
We report a case of 70-year-old woman with Sjögren’s syndrome whom it was thought to be associated with cutaneous polyarteritis nodosa.
She developed a gradual progression of dry mouth after partial replacement of her teeth at the age of 45 years. She presented in 1996, at the age of 65, with three year history of dry eyes. In June 2001, she was aware of edema and pain in both lower legs. At the same time, indurated erythemas and ulcers are seen on her lower legs. Pain, erythemas and ulcers expanded, and she was admitted to our hospital in September, 2001.
Lip biopsy revealed infiltration of lymphocytes in the salivary glands. Schirmer test was positive and sialography revealed marked destructive changes in the acinus lobules. These features justified the diagnosis of Sjögren’s syndrome.
Laboratory data revealed positive anti-SS-A antibodies and absence of MPO-ANCA. Rheumatoid factor was positive, and anti-nuclear antibody was × 640 (speckled type).
Biopsy from the skin lesion disclosed leukocytoclastic vasculitis of small arteries in the fat tissue.
Neurological examination revealed mononeuritis multiplex. These findings were compatible with the diagnosis of polyarteritis nodosa.
