Sugiyama Chihiro, Takahashi Yuichi, Fuchigami Tatsuo, Sato Satoshi, Morioka Ichiro
Department of Pediatrics, IMS Fujimi General Hospital, Fujimi, JPN.
Department of Infection, Immunology and Allergy, Saitama Children's Medical Centre, Saitama, JPN.
Cureus. 2024 Oct 30;16(10):e72730. doi: 10.7759/cureus.72730. eCollection 2024 Oct.
Sjögren's syndrome (SS), an autoimmune disease primarily affecting the exocrine glands, particularly the lacrimal and salivary glands, typically manifests as sicca symptoms (dry mouth and dry eyes). However, these symptoms are uncommon in pediatric patients. We present a case of a 13-year-old boy diagnosed with SS following the detection of bilateral parotid gland microcalcifications during a computed tomography scan for headache evaluation. The patient presented with a chief complaint of persistent headaches and malaise. However, he did not have sicca symptoms. A plain head computed tomography scan revealed multiple microcalcifications within the bilateral parotid glands. The fat-suppressed T2-weighted magnetic resonance imaging scan showed bilateral parotid gland enlargement and scattered areas of high intensity within the parotid glands. The patient was diagnosed with SS based on a serological examination and salivary and lacrimal gland disorders. Treatment with hydroxychloroquine improved headache and fatigue substantially. The patient can now participate in sports and daily life activities without difficulty. These findings stress the importance of considering SS in the differential diagnosis of children with chronic headaches and malaise. The presence of calcification within the parotid gland should raise suspicion for SS, and imaging studies can be a valuable tool for diagnosis, providing crucial information for informed decision-making.
干燥综合征（SS）是一种主要影响外分泌腺，尤其是泪腺和唾液腺的自身免疫性疾病，通常表现为口眼干燥症状（口干和眼干）。然而，这些症状在儿科患者中并不常见。我们报告一例13岁男孩，在因头痛进行计算机断层扫描时发现双侧腮腺微钙化后被诊断为干燥综合征。该患者的主要症状为持续性头痛和不适。然而，他没有口眼干燥症状。头颅平扫计算机断层扫描显示双侧腮腺内有多个微钙化。脂肪抑制T2加权磁共振成像扫描显示双侧腮腺肿大，腮腺内有散在的高信号区。根据血清学检查以及唾液腺和泪腺功能障碍，该患者被诊断为干燥综合征。使用羟氯喹治疗后，头痛和疲劳症状明显改善。该患者现在能够毫无困难地参加体育活动和日常生活。这些发现强调了在对患有慢性头痛和不适的儿童进行鉴别诊断时考虑干燥综合征的重要性。腮腺内钙化的存在应引起对干燥综合征的怀疑，影像学检查可以成为诊断的宝贵工具，为明智的决策提供关键信息。
