A 45 year old woman presents with a dry mouth, and difficulty in eating, speaking, and swallowing for 5 months. She also complains of burning and itching of her eyes, along with a foreign body sensation. Her medical and drug histories are unremarkable. There is no history of sexual promiscuity.
The ocular staining score is 3
A biopsy is obtained from the lower lip and associated salivary glands. The lip shows focal periductal and mononuclear cell infiltrate with acinar cell loss in the labial minor salivary glands.
Anti-Ro (Anti-SSA) antibodies: positive Anti-La (Anti-SSB) antibodies: positive Rheumatoid Factor: negative Antinuclear Antibodies: negative
Unstimulated whole saliva flow: 0.05 ml/min (normal: < 0.1 ml/min)