Peripheral and central nervous system involvement in a patient with primary Sjögren's syndrome: a case report
| Autor: | Franca Wagner, Mathias Sturzenegger, Kathi Ging, Marie-Luise Mono, Vera Genitsch, Martin Zbinden, Sabine Adler |
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| Přispěvatelé: | University of Zurich, Wagner, Franca |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
10017 Institute of Anatomy Fulminant medicine.medical_treatment lcsh:Medicine 610 Medicine & health Case Report 2700 General Medicine 030204 cardiovascular system & hematology Polyneuropathies 03 medical and health sciences Magnetic resonance imaging 0302 clinical medicine Central Nervous System Diseases Polyneuropathy Humans Medicine Xerophthalmia medicine.diagnostic_test business.industry lcsh:R General Medicine Middle Aged medicine.disease Cryoglobulinemia Dermatology Hyperintensity Sjogren's Syndrome Treatment Outcome Central nervous system Antirheumatic Agents Sjögren’s syndrome 030220 oncology & carcinogenesis Rheumatoid arthritis 570 Life sciences biology Female Plasmapheresis Rituximab business Switzerland |
| Zdroj: | Journal of Medical Case Reports, Vol 13, Iss 1, Pp 1-7 (2019) Journal of Medical Case Reports 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 |
| DOI: | 10.7892/boris.131185 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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