background: sj?gren’s syndrome is an autoimmune syndrome involving the exocrine glands specially the salivary and lacrimal glands leading to xerostomia and xerophtalmia. this paper presents a case with primary sj?gren’s syndrome that severe dental caries were the first clinical manifestation. case presentation: a 42-year-old man was referred to the school of dentistry, tehran university of medi...

I read the recent publication on cytotoxic T lymphocyte antigen-4 (CTLA-4) A49G polymorphism with a great interest [1]. Aktürk et al. concluded that, “these data suggest that CTLA-4 A49G polymorphism does not contribute to the pathogenesis of lymphoproliferative diseases itself, nor does it increase the risk of autoimmune complications in patients with lymphoproliferative disease [1].” Aktürk e...

Splenic Lymphoma with villous lymphocytes (SLVL) is a B cell chronic lymphoproliferative disorder defined in the WHO classification as the leukemic form of splenic marginal zone lymphoma. Autoimmune diseases or second neoplasms in patients affected by B cell chronic lymphoproliferative disorders are well known conditions after fludarabine containing regimens (above all in the case of Chronic Ly...

Myasthenia gravis (MG), a neuromuscular junction autoimmune disease, sometimes complicates second malignancies; however, T-cell lymphoproliferative disorders have rarely been reported. A 55-year-old man, who received oral tacrolimus and prednisolone for MG for 16 years after thymectomy, presented with left abdominal pain, lymphadenopathy, and splenomegaly. A lymph node biopsy revealed periphera...