Case of May 2008

Clinical History:

A 42-year-old lady, who previously enjoyed good past health, has been suffering from progressive dry eye and dry mouth for 6 months. She was afebrile all along. Physical examination revealed painless enlargement of both parotid glands. Blood test for autoimmune markers found positive for anti-nuclear antibody. MRI orbit and neck was performed (T2W, T2W FS, T1W images):