Extended report
Involvement of the peripheral nervous system in primary
Sjögren's syndrome
P J Barendregta, M J van den Bentb, V J M van Raaij-van den Aarssenb, A H van den Meirackerc, Ch J Vechtb, G L van der Heijded, H M Markussea
a Department of
Rheumatology, Zuiderziekenhuis, Rotterdam, The Netherlands, b Department of
Neuro-Oncology, Dr Daniel den Hoed Cancer Centre Academic Hospital
Rotterdam, Rotterdam, The Netherlands, c Department of Internal Medicine I, Academic
Hospital Rotterdam, Dijkzigt, Rotterdam, The Netherlands, d Department
of Clinical Physics and Informatics, Academic Hospital, Free
University, Amsterdam, The Netherlands
Correspondence to: Dr P J Barendregt, Department of Rheumatology, Medisch Spectrum Twente, PO Box 50.000, 7500 KA Enschede, The Netherlands pjbarendregt{at}zeelandnet.nl
Accepted for publication 30 January
2001
BACKGROUND
Involvement
of the peripheral nervous system in patients with primary Sjögren's
syndrome (SS) has been reported, but its prevalence in neurologically
asymptomatic patients is not well known.
OBJECTIVE
To assess
clinical and neurophysiological features of the peripheral nervous
system in patients with primary SS.
PATIENTS AND
METHODS
39 (38 female) consecutive patients with
primary SS, aged 20-81 years (mean 50), with a disease duration of
1-30 years (mean 8) were studied. The peripheral nervous system was
evaluated by a questionnaire, physical examination, quantified sensory
neurological examination, and neurophysiological measurements (nerve
conduction studies). To assess autonomic cardiovascular function an
orthostatic challenge test, a Valsalva manoeuvre, a forced respiration
test, and pupillography were done.
RESULTS
Abnormalities
as indicated in the questionnaire were found in 8/39 (21%) patients,
while an abnormal neurological examination was found in 7/39 (18%)
patients. Abnormalities in quantified sensory neurological examination
were found in 22/38 (58%) patients. In 9/39 (23%) patients,
neurophysiological signs compatible with a sensory polyneuropathy were
found. No differences were found in the autonomic test results, disease
duration, serological parameters, or erythrocyte sedimentation rate
between the patients with primary SS with and those without evidence of
peripheral nervous involvement.
CONCLUSION
Subclinical
abnormalities of the peripheral nervous system may occur in patients
with primary SS selected from a department of rheumatology, but
clinically relevant involvement of the peripheral nervous system in
this patient group is rare.
© 2001 by Annals of the Rheumatic Diseases
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