Abstract
Early-onset primary Sjögren's syndrome is rare and may present atypically in pediatric patients. We report a 14-year-old female who presented with bilateral parotid swelling and oral dryness. Contrast-enhanced computed tomography revealed diffuse glandular enlargement with numerous tiny punctate radiopaque foci. Minor salivary gland biopsy confirmed focal lymphocytic sialadenitis with approximately 50 lymphocytes per high-power field and mild acinar atrophy. Diagnosing this syndrome in children can be challenging due to its rarity and overlapping symptoms with other inflammatory or infectious conditions. Recognizing these subtle early features is essential, as delayed diagnosis may lead to irreversible glandular damage and systemic complications. This case emphasize the importance of early recognition and supports the diagnostic value of minor salivary gland biopsy in confirming the disease.