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Involvement of the peripheral nervous system in primary Sjögren's syndrome
  1. P J Barendregta,
  2. M J van den Bentb,
  3. V J M van Raaij-van den Aarssenb,
  4. A H van den Meirackerc,
  5. Ch J Vechtb,
  6. G L van der Heijded,
  7. H M Markussea
  1. aDepartment of Rheumatology, Zuiderziekenhuis, Rotterdam, The Netherlands, bDepartment of Neuro-Oncology, Dr Daniel den Hoed Cancer Centre Academic Hospital Rotterdam, Rotterdam, The Netherlands, cDepartment of Internal Medicine I, Academic Hospital Rotterdam, Dijkzigt, Rotterdam, The Netherlands, dDepartment of Clinical Physics and Informatics, Academic Hospital, Free University, Amsterdam, The Netherlands
  1. Dr P J Barendregt, Department of Rheumatology, Medisch Spectrum Twente, PO Box 50.000, 7500 KA Enschede, The Netherlandspjbarendregt{at}zeelandnet.nl

Abstract

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.

  • Sjögren's syndrome
  • peripheral nervous system

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