Differential Diagnosis for Dry Mouth and Dry Eyes with Tender, Swollen Salivary Glands
Single Most Likely Diagnosis
- Sjögren's Syndrome: This autoimmune disorder is characterized by exocrine gland dysfunction, leading to dry eyes (xerophthalmia) and dry mouth (xerostomia), along with potential swelling of the salivary glands. The chronic nature of the symptoms over six months aligns with the typical presentation of Sjögren's Syndrome.
Other Likely Diagnoses
- Sarcoidosis: This condition can cause inflammation in various parts of the body, including the salivary glands, leading to swelling and tenderness, and can also cause dry eyes and mouth due to glandular involvement.
- Hepatitis C: Some patients with hepatitis C may develop Sjögren's Syndrome or experience similar symptoms due to the autoimmune nature of the disease, including dry eyes and mouth, and salivary gland swelling.
- Lymphoma: Although less common, lymphoma can infiltrate the salivary glands, causing swelling and tenderness, and may also lead to symptoms of dry mouth and eyes, especially if there is associated Sjögren's Syndrome.
Do Not Miss Diagnoses
- Lymphoma (Hodgkin's or Non-Hodgkin's): Given its potential severity and the need for early intervention, it's crucial not to miss lymphoma, which can present with salivary gland swelling and systemic symptoms.
- Tuberculosis: Although rare in some regions, tuberculosis can affect the salivary glands and cause chronic symptoms similar to those described, making it a diagnosis that should not be overlooked due to its treatability and potential severity.
- Sialadenitis (bacterial or viral): Infections of the salivary glands can cause acute or chronic swelling and tenderness, and while often less likely to cause long-term dry eyes and mouth, they are important to consider due to the need for specific treatment.
Rare Diagnoses
- IgG4-Related Disease: This condition can cause inflammation in various glands, including the salivary glands, leading to swelling and potentially symptoms of dry mouth and eyes, though it is less common.
- Granulomatosis with Polyangiitis (formerly Wegener's Granulomatosis): A rare autoimmune disorder that can affect multiple systems, including causing inflammation in the salivary glands and potentially leading to dry eyes and mouth.
- Hemochromatosis: Although primarily known for iron overload, in rare cases, it can lead to glandular dysfunction, including the salivary glands, potentially causing similar symptoms.