Association manifestations psychopathologiques, syndromes de la bouche brûlante et de Sjögren chez une patiente ménopausée : complexité diagnostique et thérapeutique

Background: According to the International Classification of Orofacial Pain, burning mouth syndrome is a form of orofacial pain that may or may not be accompanied by somatosensory changes. Its etiopathogenesis remains uncertain and is likely multifactorial; the hypothesis that it may be psychogenic has been the subject of extensive research. Sjögren’s syndrome, a chronic inflammatory autoimmune disease, typically presents with a combination of dryness, pain, and fatigue. Clinical and epidemiological similarities between these conditions can complicate the diagnostic process. This case report, set in an African context, describes the coexistence of both conditions in a single patient, highlighting the diagnostic odyssey and the challenges in clinical management that ensued. Methods: A retrospective qualitative analysis was conducted on the medical record of a patient referred to a psychiatric department by a stomatologist, following several years of diagnostic uncertainty. The assessment was based on international classification systems and three standardized instruments: the Hamilton Anxiety Rating Scale, the Pittsburgh Sleep Quality Index (PSQI), and the Short Form Health Survey (SF-36). Case presentation: The patient, Fatou, underwent several months of psychiatric follow-up for initially imprecise diagnoses. Her medical, surgical, and psychiatric history was unremarkable, with the exception of sickle cell trait. The fluctuating course of her condition and specific clinical features prompted a more in-depth medical history (anamnesis). Burning mouth syndrome was considered, followed by a diagnosis of Sjögren’s syndrome, which was subsequently confirmed by an internist. Re-evaluating the diagnosis and adjusting the treatment plan led to significant clinical improvement. Conclusion: The coexistence of burning mouth syndrome and Sjögren’s syndrome presents both diagnostic and therapeutic challenges. This case also underscores the potential role of cultural factors in the expression of symptoms—and possibly in the etiopathogenesis of burning mouth syndrome itself.