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Quiz Question of the week from StatPearls
A patient has signs and symptoms of Sjogren syndrome. However, at the angle of the mandible on the right, in the area of the parotid gland, there is a mildly tender, hard, nodular swelling.
Laboratories show an erythrocyte sedimentation rate of 40 mm/ hour and C-reactive protein of 0.7. SSA, SSB, and double-stranded-DNA are all negative. There is no monoclonal protein on serum
protein electrophoresis (SPEP). There are diffusely elevated globulins, as well as an elevated rheumatoid factor (RF). A chest x-ray is normal. MRI shows an enlarged left parotid gland,
with an ill-defined 2 x 2 x 2.5-cm dense signal in the center with no neurovascular compromise. What would be the most appropriate step in the management of this patient?
A) Lip biopsy
B) Mass biopsy
C) Artificial tears and observation
D) Prednisone 20 mg per day, calcium 500 mg BID, and vitamin D 400 international units per day
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