Case Report
SLE and dental erosion: a lethal cocktail David Fegan1 and Mary Jacqueline Glennon2
Tropical Doctor 2014, Vol. 44(2) 122–123 ! The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0049475514521805 tdo.sagepub.com
Abstract A 13-year-old Pacific Island girl presented complaining of fever, joint pain and dry mouth. She was using limes to relieve her dry mouth. On examination, the most striking clinical finding was severe dental erosion and caries. Autoimmune serology confirmed a diagnosis of systemic lupus erythematosus (SLE) with possible Sjo¨gren’s syndrome. The case illustrates the devastating consequence of excessive consumption of acidic citrus juice in sicca syndrome.
Keywords Pacific Islands, immune
Case Report A 13-year-old girl presented with a 2-year history of fever, malaise and joint pains. She was diagnosed with chronic juvenile arthritis in 2008 but was lost to follow-up. She presented again in 2010 with similar complaints but now also with dry mouth and excessive thirst, which was relieved by sucking limes. On examination, she was febrile and thin with sparse hair. Her left ankle and right wrist were swollen and tender. There was no rash, however she had severe dental erosion with caries (Figure 1), dry lips, and oral mucosa and tongue. Initial investigations in 2008 revealed ESR >100 mm/h. Rheumatoid factor and ANA were negative at that time. Investigations in 2010: Hb 9.8 g/dl, WBC 7 109/L, lymphocytes 3.1 109/L, ANA > 2,560 homogeneous, anti-dsDNA 52 IU/mL, Rheumatoid factor
SLE and dental erosion: a lethal cocktail David Fegan1 and Mary Jacqueline Glennon2
Tropical Doctor 2014, Vol. 44(2) 122–123 ! The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0049475514521805 tdo.sagepub.com
Abstract A 13-year-old Pacific Island girl presented complaining of fever, joint pain and dry mouth. She was using limes to relieve her dry mouth. On examination, the most striking clinical finding was severe dental erosion and caries. Autoimmune serology confirmed a diagnosis of systemic lupus erythematosus (SLE) with possible Sjo¨gren’s syndrome. The case illustrates the devastating consequence of excessive consumption of acidic citrus juice in sicca syndrome.
Keywords Pacific Islands, immune
Case Report A 13-year-old girl presented with a 2-year history of fever, malaise and joint pains. She was diagnosed with chronic juvenile arthritis in 2008 but was lost to follow-up. She presented again in 2010 with similar complaints but now also with dry mouth and excessive thirst, which was relieved by sucking limes. On examination, she was febrile and thin with sparse hair. Her left ankle and right wrist were swollen and tender. There was no rash, however she had severe dental erosion with caries (Figure 1), dry lips, and oral mucosa and tongue. Initial investigations in 2008 revealed ESR >100 mm/h. Rheumatoid factor and ANA were negative at that time. Investigations in 2010: Hb 9.8 g/dl, WBC 7 109/L, lymphocytes 3.1 109/L, ANA > 2,560 homogeneous, anti-dsDNA 52 IU/mL, Rheumatoid factor
