A 42-year-old woman comes to the emergency department due to worsening jaw pain over the past week. She is unable to chew solid foods on the left side because of severe throbbing pain. The patient has had several "tooth infections" over the last year despite meticulous oral hygiene. Physical examination shows facial edema over the left mandible. Multiple teeth have decay and gingival recession, and gentle tapping of the left second molar elicits pain. This patient's current disease process is most likely to develop secondary to which of the following underlying conditions?

Question

A 42-year-old woman comes to the emergency department due to worsening jaw pain over the past week.  She is unable to chew solid foods on the left side because of severe throbbing pain.  The patient has had several "tooth infections" over the last year despite meticulous oral hygiene.  Physical examination shows facial edema over the left mandible.  Multiple teeth have decay and gingival recession, and gentle tapping of the left second molar elicits pain.  This patient's current disease process is most likely to develop secondary to which of the following underlying conditions?

Quizplus · Accepted Answer

Eductional Objective: Sjögren syndrome is characterized by autoimmune inflammation of exocrine glands (eg, salivary, lacrimal, vaginal).  Patients typically have severe dry mouth (xerostomia) due to reduced saliva production, which can lead to an increased rate of dental caries and other oral infections (eg, thrush) because of the loss of protective factors in saliva.  Biopsy of the salivary glands shows a lymphocytic infiltrate, often with germinal centers.

A 42-Year-Old Woman Comes to the Emergency Department Due to Worsening