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Sjögren Syndrome — RACP Adult Medicine MCQ

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HardRheumatologySjögren SyndromeRACP Adult Medicine

A 58-year-old with established Sjogren syndrome develops persistent unilateral parotid enlargement, weight loss, palpable purpura and low complement. What is the most important next step?

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Correct answer: CArrange urgent expert assessment and tissue diagnosis for possible lymphoma

The best answer is “Arrange urgent expert assessment and tissue diagnosis for possible lymphoma”. Sjögren syndrome increases B-cell lymphoma risk; persistent asymmetric salivary enlargement, systemic symptoms, purpura and hypocomplementaemia are red flags. Imaging and appropriately targeted biopsy should precede empiric immunosuppression when feasible because treatment can obscure histology. Symptomatic sicca care does not address a possible malignancy.

Reference: Australian Rheumatology Association: Sjogren syndrome: https://rheumatology.org.au/For-Patients/Adult-Medication-Information