Patterns of peripheral neuropathy in Sjogren's syndrome in a tertiary care hospital from South India

Autor:	Gampa Sandeep, Anjan Pyal, Liza Rajasekhar, Shaik Afshan Jabeen, Rupam Borgohain, Yareeda Sireesha, Megha S Uppin, Rukmini Mridula Kandadai, Meena A Kanikannan, Mathukumalli L Neeharika, Rajendra Varaprasad
Rok vydání:	2019
Předmět:	Male medicine.medical_specialty Neurology India Tertiary Care Centers Internal medicine medicine Schirmer's test Humans Retrospective Studies Nerve biopsy medicine.diagnostic_test business.industry Peripheral Nervous System Diseases Polyradiculoneuropathy medicine.disease Dermatology Rheumatology Peripheral neuropathy Sjogren's Syndrome Female Neurology (clinical) business Vasculitis Anti-SSA/Ro autoantibodies
Zdroj:	Neurology India. 67
ISSN:	0028-3886
Popis:	Introduction: Sjogren's syndrome (SS) is a systemic autoimmune disease that apart from involving the exocrine glands can affect any organ. Involvement of the peripheral nervous system results in a wide spectrum of neuropathic manifestations. Objective: To evaluate the clinico-electrophysiological patterns as well as pathological characteristics of neuropathy in SS patients presenting to a neuromuscular clinic in a tertiary hospital from South India. Materials and Methods: This is a retrospective study from the Departments of Neurology, Rheumatology, and Pathology from Nizam's Institute of Medical Sciences. Twenty-one patients with the diagnosis of SS and peripheral neuropathy, seen between 2010 and 2016 were analyzed. Clinical records, conventional nerve conduction studies, and lip and nerve biopsy reports were collected. Results: Twenty one patients with SS had associated neuropathy. Female-to-male ratio was 2:1. In 14 (66.7%) patients, neuropathy was the initial manifestation, while in 4 (20%), exocrinopathy preceded neuropathy. The patterns of neuropathy included mononeuropathy multiplex (MNM) in 7 patients (30%), ganglionopathy in 4 (20%), length-dependant trigeminal autonomic neuropathy, and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) in 2 (10%), and cranial neuropathy in 1 (10%). Eighteen (86%) were seropositive with either anti Ro/SS-A or anti La/SS-B antibodies. Schirmer's test was positive in 13 (61.9%) patients. Nerve biopsy showed vasculitis in 5 patients and demyelinating and axonopathy in 2 patients each. Conclusions: We conclude that neuropathy is frequently the initial presentation of SS. MNM is the most common pattern followed by ganglionopathy. The pattern of neuropathy helps in arriving at the diagnosis of SS. Serology is a useful initial laboratory test. However,confirmation of SS is not by mere serology. Schirmer's test and lip biopsy are equally essential for the diagnosis, especially in seronegative patients when the clinical index of suspicion is high.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::45c9b389201e7276beb7dd6270e6cd5b https://pubmed.ncbi.nlm.nih.gov/30688241 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.