Diagnostic différentiel des syndromes secs et parotidomégalies

Eye and/or mouth dryness (or sicca syndrome) is a very common complaint, increasing with age, and causing a profound decrease of the quality of life. Several conditions can cause a sicca syndrome, including primary Sjögren's syndrome (pSS). pSS is characterized by sicca syndrome, frequently associated with recurrent swelling of the salivary glands, due to a lymphocyte infiltration of the exocrine glands. Systemic manifestations are also possible in half of the patients, and the main complication is the development of non-Hodgkin's lymphoma. The clinician must know how to rule out several differential diagnoses, in order to recognize early the conditions that require specific treatments. This review presents some other causes of sicca syndrome (medications, chronic viral infections, graft-versus-host disease) and swelling of the salivary glands (granulomatosis with polyangiitis, sarcoidosis, IgG4-related disease…), which could be mistaken for atypical pSS.