[36F] With chronic dry nose, eyes, and itchy ear

Patient Description

A 36-year-old female presents with a constant, extremely dry nose with sores for about 3 months. Saline spray provides only short relief. The dryness appeared suddenly without any changes in environment or lifestyle. Additionally, she experiences dry eyes intermittently for a couple of years, sometimes accompanied by redness but no discharge. She occasionally experiences dry mouth. Joint pain is present, particularly in the knees and ankles, with occasional swelling. Family history includes Graves' disease, Guillain-Barré syndrome, diabetes, chronic hives/asthma, and arthritis. The patient's medical history includes polycystic ovary syndrome (PCOS), eczema, sciatica, carpal tunnel syndrome, unstable ankles, chronic fatigue, and insomnia.

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Arora's Assessment

What might be happening

Based on the symptoms and history you've provided, here are some possible explanations:

Dry Nose, Dry Eyes, and Dry Itchy Ear

  • Sjogren's Syndrome: This is an autoimmune disorder that primarily affects the glands that produce tears and saliva, leading to dry eyes and dry mouth. It can also cause dryness in other areas, such as the nose and ears. Given your family history of autoimmune diseases, this could be a possibility.
  • Environmental Factors: Dry air, especially from heating or air conditioning, can cause dryness in the nose and eyes. However, since you mentioned no changes in your environment, this might be less likely.
  • Medication Side Effects: Some medications can cause dryness as a side effect. Since you haven't mentioned any new medications, this might not be the cause.

Joint Pain and Swelling

  • Rheumatoid Arthritis: This is another autoimmune disorder that causes joint pain and swelling. Given your family history and symptoms, this could be a possibility.
  • Osteoarthritis: This is a degenerative joint disease that can cause pain and swelling, especially in weight-bearing joints like the knees and ankles.

Unifying Diagnosis

  • Autoimmune Disorder: Given your family history and the range of symptoms (dryness, joint pain, swelling), an autoimmune disorder like Sjogren's Syndrome or Rheumatoid Arthritis could be a unifying diagnosis.

What you can do

Dry Nose, Dry Eyes, and Dry Itchy Ear

  • See a Doctor: It's important to consult a healthcare provider to rule out autoimmune disorders like Sjogren's Syndrome. They may recommend blood tests and other diagnostic procedures.
  • Hydration: Drink plenty of water to stay hydrated.
  • Humidifier: Use a humidifier in your home to add moisture to the air.
  • Saline Sprays: Continue using saline sprays for temporary relief, but consult your doctor for more effective treatments.

Joint Pain and Swelling

  • Consult a Rheumatologist: Given your symptoms and family history, seeing a specialist in autoimmune diseases and joint disorders is advisable.
  • Over-the-Counter Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help manage pain and swelling.
  • Physical Therapy: Exercises to strengthen the muscles around your joints can help alleviate pain and improve function.

General Tips

  • Symptom Journal: Use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider. This can help in diagnosing and managing your condition.
  • Healthy Diet: A balanced diet rich in anti-inflammatory foods like fruits, vegetables, and omega-3 fatty acids can help manage symptoms.

What you should look out for

Given the complexity and potential seriousness of your symptoms, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Severe Joint Swelling or Pain: This could indicate a more serious underlying condition.
  • Vision Changes: Any changes in vision should be evaluated immediately.
  • Severe Dryness: If the dryness in your nose, eyes, or mouth becomes unbearable or leads to other complications, seek medical attention.

Remember, while I can provide information and suggestions, it's crucial to consult a healthcare professional for a formal diagnosis and treatment plan.

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4 mo ago


People Also Ask


What is Sjogren's Syndrome and how is it diagnosed?

Sjogren's Syndrome is an autoimmune disorder that primarily affects the glands that produce tears and saliva, leading to dry eyes and mouth. It can also cause dryness in other areas, such as the nose and ears. Diagnosis typically involves blood tests to check for specific antibodies, a Schirmer's test to measure tear production, and sometimes a lip biopsy.


Can joint pain and swelling be related to autoimmune disorders?

Yes, joint pain and swelling can be related to autoimmune disorders such as Rheumatoid Arthritis and Sjogren's Syndrome. These conditions occur when the immune system mistakenly attacks the body's own tissues, leading to inflammation and pain in the joints.


What are some effective treatments for chronic dry nose and eyes?

For chronic dry nose and eyes, treatments may include using artificial tears or lubricating eye drops, applying nasal saline sprays, using a humidifier to add moisture to the air, and staying well-hydrated. In some cases, medications that stimulate saliva and tear production or immunosuppressive drugs may be prescribed by a doctor.


How can family history influence the likelihood of developing autoimmune disorders?

Family history can significantly influence the likelihood of developing autoimmune disorders, as these conditions often have a genetic component. If close family members have autoimmune diseases, it may increase an individual's risk of developing similar conditions.


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