A patient with rheumatoid arthritis

[Oak]

A patient with rheumatoid arthritis mentions to her physician that after many years without dental problems, she has recently had seven dental caries filled. This finding suggests that she should be evaluated for which of the following diseases?

A. Oral squamous cell carcinoma
B. Polyarteritis nodosa
C. Sjögren's syndrome
D. Systemic lupus erythematosus
E. Thyrotoxicosis

[santoshkhanal]

Originally Posted by Oak

A patient with rheumatoid arthritis mentions to her physician that after many years without dental problems, she has recently had seven dental caries filled. This finding suggests that she should be evaluated for which of the following diseases?

A. Oral squamous cell carcinoma
B. Polyarteritis nodosa
C. Sjögren's syndrome
D. Systemic lupus erythematosus
E. Thyrotoxicosis

i think that the patient should be evaluated for sjogren's syndrome which is an auto immune condition leading to the dryness of mouth but RA itself can cause destruction of salivary gland and cause dental caries............so i think the answer is c

[bharat]

I will also go for C. Sjögren's syndrome
because this disease is characterised by :-
keratoconjunctivitis sicca, dryness of mucous membranes, telangiectasias or purpuric spots on the face, and bilateral parotid enlargement, seen in menopausal woman, and often associated with rheumatoid arthritis, Raynaud's phenomenon, and dental caries; there are changes in the lacrimal and salivary glands resembling those of Mikulicz' disease.
so i hope c is correct answer.

[Oak]

Yh thats right the correct answer is C. Rheumatoid arthritis can coexist with a variety of autoimmune diseases (including those listed in the answers), but is most frequently associated with Sjögren's syndrome. Sjögren's syndrome classically presents with keratoconjunctivitis (dry eyes) and xerostomia (dry mouth, often resulting in dental caries and fissures in the oral mucosa). These symptoms are due to autoimmune involvement with subsequent scarring of the salivary and lacrimal glands. Parotid gland enlargement is common, as is vasculitis, Raynaud's phenomenon, hyperviscosity syndrome, and peripheral neuropathy.

The development of oral squamous cell carcinoma (choice A) is not related to the presence of dental caries.

Polyarteritis nodosa (choice B) is a systemic necrotizing vasculitis. Patients typically present with low-grade fever, weakness, and weight loss. Abdominal pain, hematuria, renal failure, hypertension, and leukocytosis may occur.

Systemic lupus erythematosus (choice D) is an autoimmune disease characterized by vasculitis, rash, renal disease, hemolytic anemia, and neurologic disturbances.

Thyrotoxicosis (choice E) is not related to the development of dental caries.