Primary Biliary Cirrhosis and Primary Sjögren's Syndrome: Insights for the Stomatologist

• Published in: Case reports in gastroenterology Vol. 8; no. 2; pp. 251 - 256
• Main Authors: Lins, Liliane, Paraná, Raymundo, Reis, Silvia Regina Almeida, Pereira Falcão, Antônio Fernando
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 30-08-2014; Karger Publishers
• Subjects: Liver cirrhosis; Oral health; Primary biliary cirrhosis; Published: August 2014; Sjögren’s syndrome; Primary biliary cirrhosis; Sjögren’s syndrome; Liver cirrhosis; Oral health; Sjögren's syndrome
• ISSN: 1662-0631; 1662-0631
• DOI: 10.1159/000367595

Primary biliary cirrhosis (PBC) is a chronic progressive autoimmune disease characterized by portal inflammation and immune-mediated destruction of the intrahepatic bile ducts. Primary Sjögren's syndrome is an autoimmune disease characterized by lymphocytic infiltration of exocrine glands, mainly the lachrymal and salivary glands, in the absence of other definitively diagnosed rheumatologic disease. We report a diagnosed case of primary Sjögren's syndrome associated with PBC. A 59-year-old Caucasian woman went to oral evaluation reporting dry mouth, difficulty in eating associated with burning mouth syndrome, dysgeusia and dysphagia. Intraoral examination revealed extensive cervical caries, gingivitis, gingival retraction, angular cheilitis and atrophic tongue. Hyposalivation was detected by salivary flow and Schirmer's test was positive. Antinuclear and antimitochondrial antibodies were both positive. Anti-Ro/SSA and anti-La/SSB antibodies were negative. A minor salivary gland biopsy of the lower lip was performed. Histopathologic analysis revealed lymphocytic infiltrate with destruction of salivary gland architecture in some areas and replacement of glandular tissues by mononuclear cells. Optimal management of PBC associated with Sjögren's syndrome requires a multidisciplinary approach as the key to optimal patient care. Dental practitioners should be able to recognize the clinical features of this associated condition. Appropriate dental care may prevent tooth decay, periodontal disease and oral infections as well as improve the patient's quality of life.