Work

From breast mass to paralysis: lymphocytic mastitis as the sentinel manifestation of Sjögren’s syndrome

Year: 2026

Type: article

Abstract: Sjögren's syndrome is a systemic autoimmune disease classically characterized by sicca symptoms; however, extra glandular manifestations may precede glandular involvement and, in rare cases, present as life threatening emergencies. We report a middle-aged patient who presented with acute flaccid paralysis due to severe hypokalaemia secondary to distal renal tubular acidosis, requiring intensive care admission. Notably, the patient had undergone breast excision two years earlier for a painful breast mass, with histopathology highly suggestive of lymphocytic mastitis, which was misdiagnosed and treated as a breast abscess. Subsequent immunological evaluation confirmed primary Sjögren's syndrome. Prompt electrolyte correction and immunosuppressive therapy resulted in complete neurological recovery. LEARNING POINTS: Sjögren's syndrome may initially present with rare extra glandular manifestations, preceding classical sicca symptoms and leading to significant diagnostic delay.Lymphocytic mastitis can represent an early autoimmune manifestation of Sjögren's syndrome and may closely mimic infectious or malignant breast disease.Distal renal tubular acidosis is the most frequent renal manifestation of Sjögren's syndrome and may result in life-threatening hypokalemia and acute flaccid paralysis.

Source: European Journal of Case Reports in Internal Medicine

DOI: 10.12890/2026_006125

Authors: Khawla K. Alghanim, Rana K. Almuqati, Hanan T. Albaqshi, Nayef S. Alahmadi

Institution: King Fahd Military Medical Complex

Language: English

Topic: Salivary Gland Disorders and Functions

Subfield: Physiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $323