Echocardiography showed that she had rheumatic valvular heart disease, cardiac ejection fraction (EF) was 63%, left and right atrium were enlarged, left ventricular diastolic function was reduced and mild pulmonary hypertension (pulmonary artery systolic pressure, PASP, 45 mmHg). The Color Doppler ultrasound of temporal arteries showed that the wall of the bilateral temporal artery was thickened, the width of the lumen was varied, and the blood flow bundle became thinner, and these results suggested temporal arteritis (Figures 1A and 1B). After admission to our hospital, the combination of methylprednisolone (20 mg/qd), hydroxychloroquine (0.2 g/bid) and tripterygium glycoside (20 mg/tid) with anti-inflammatory therapy gradually alleviated the joint pain and headache of the patient, with no obvious improvement in blurred vision. In order to exclude the presence of diseases such as brain tumors, she was examined by the cerebral magnetic resonance imaging (MRI), and the result showed that there was a softening lesion in her right cerebellar hemisphere (Figures 1C and 1D). She said she had been suffering from dry eyes and dry mouth. In order to determine whether she had SS, an ophthalmologist was invited for consultation. By detecting the break-up time (BUT) in both eyes, the doctor found that her right eye was 5.09 s, left eye was 1.61 s (normal > 10 s), and the height of double tears river was 0.1 mm (normal > 0.2 mm).