A 13-year-old Pacific Island girl presented complaining of fever, joint pain and dry mouth. She was using limes to relieve her dry mouth. On examination, the most striking clinical finding was severe dental erosion and caries. Autoimmune serology confirmed a diagnosis of systemic lupus erythematosus (SLE) with possible Sjögren’s syndrome. The case illustrates the devastating consequence of excessive consumption of acidic citrus juice in sicca syndrome.
MarmorMFKellnerULaiTYLyonsJSMielerWF. American Academy of Ophthalmology. Revised recommendations on screening for chloroquine and hydroxychloroquine retinopathy. Ophthalmology2011; 118: 415–422.
2.
ConnellyKMorandEFHoiAY. Asian ethnicity in systemic lupus erythematosus: an Australian perspective. Intern Med J2013; 43: 618–624.
3.
ConcannonARudgeSYanJReedP. The incidence, diagnostic clinical manifestation and severity of juvenile systemic lupus erythematosus in New Zealand Maori and Pacific Island children: the Starship experience (2000–2010). Lupus2013; 22: 1156–1161.
4.
YaoQAltmanRDWangX. SLE and Sjogrens syndrome compared to systemic lupus erythematosus alone: a meta-analysis. J Clin Rheumatol2012; 18: 28–32.
5.
SheldonJ. Laboratory testing in autoimmune rheumatic diseases. Best Pract Res Clin Rheumatol2004; 18: 249–269.
