Peripheral and central nervous system involvement in a patient with primary Sjögren's syndrome: a case report.

Ging, Kathi; Mono, Marie-Luise; Sturzenegger, Mathias; Zbinden, Martin; Adler, Sabine; Genitsch Gratwohl, Vera; Wagner, Franca (2019). Peripheral and central nervous system involvement in a patient with primary Sjögren's syndrome: a case report. Journal of medical case reports, 13(1), p. 165. BioMed Central 10.1186/s13256-019-2086-8

[img]
Preview
Text
document.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (2MB) | Preview

BACKGROUND Primary Sjögren's syndrome is the second most common rheumatological disorder after rheumatoid arthritis. It typically presents as xerophthalmia and xerostomia in postmenopausal women. Involvement of the central nervous system has been recognized, although its pathogenesis and characteristics are poorly understood. Central nervous system complications are a diagnostic challenge and emphasize the need for systematic screening of patients with new peripheral and central neurological symptoms. CASE REPORT We report a case of a 58-year-old Swiss woman presenting with rapidly progressive sensorimotor distal polyneuropathy together with new-onset generalized seizures. Initial magnetic resonance imaging (MRI) of the brain performed after the first seizure showed multiple, bihemispheric, confluent white matter hyperintensities with contrast enhancement. Follow-up imaging 3 days after the initial magnetic resonance imaging demonstrated a fulminant disease progression associated with the serious clinical deterioration of the patient. In light of the results of a minor salivary gland biopsy, autoantibody testing, nerve conduction studies, and cranial magnetic resonance imaging, primary Sjögren's syndrome with cryoglobulinemia type II was diagnosed. Response to plasmapheresis and subsequent administration of cyclophosphamide was favorable. CONCLUSION Even though exocrinopathy is the hallmark of Sjögren's syndrome, systemic symptoms are observed in one-third of patients. There is an urgent need to better characterize the mechanisms underlying different disease phenotypes and to perform randomized controlled trials in order to provide tailored and evidence-based treatment for primary Sjögren's syndrome.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute of Pathology
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology, Clinical Immunology and Allergology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Ging, Kathi; Mono, Marie-Luise; Zbinden, Martin; Adler, Sabine; Genitsch Gratwohl, Vera and Wagner, Franca

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

1752-1947

Publisher:

BioMed Central

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

18 Jul 2019 09:31

Last Modified:

21 Jul 2019 02:40

Publisher DOI:

10.1186/s13256-019-2086-8

PubMed ID:

31126347

Uncontrolled Keywords:

Central nervous system Magnetic resonance imaging Polyneuropathy Sjögren’s syndrome

BORIS DOI:

10.7892/boris.131185

URI:

https://boris.unibe.ch/id/eprint/131185

Actions (login required)

Edit item Edit item
Provide Feedback