Pulmonary infiltrates and abdominal colic pain in a patient with a connective tissue disorder

[...]thyroid function should be examined in SS patients with extreme tiredness, 2 because autoimmune thyroiditis has been reported in up to 10% of SS patients. 3 The diagnosis of primary SS was established after demonstrating exocrine involvement by Schirmer's test and salivary gland histopathology together with a suggestive autoimmune profile. [...]the most challenging situation in diagnostic terms occurs in patients presenting with parenchymal internal organ disease without obvious surface exocrine disease. 7 Indeed, a wide variety of onset forms have been described in SS (table 1 ).