Background Sjögren's syndrome is an autoimmune rheumatic disease that affects many glandular and extra-glandular tissues (1). Autoantibodies (mainly anti-Ro-SS-A and anti-La-SS-B) contribute to playing roles in its clinical pictures (2). Central and peripheral nervous system involvement may be seen as different sign, symptoms and varying its frequencies (2).
Objectives The aim of this study is to investigate the frequency of neurological and other involvement patterns of the Sjögren's syndrome (SjS).
Methods Between June 2015 and December 2015, fifty-eight-SjS patients that following-up at Cumhuriyet University Medical Faculty Rheumatology-Internal Medicine Department were evaluated in the study. The clinical complaints, glandular and extra-glandular findings, age, sex, other epidemiological data, ANA, RF, anti-Ro/La, C3, C4, IgG, IgA, IgM levels were recorded.
Results The mean age of the patients was 47.8±1.3 years, and the mean age at diagnosis was 46.8±1.2 years. Of the SjS patients, fifty-four (93.1%) were female and four (6.9%) were male. The frequencies of the clinical symptoms were as follows arthralgia in 81%, arthritis in 48.3%, skin dryness in 50%, rashes (including palpable purpuric lesions) in 17.2%, biopsy proven vasculitic lesions in 5.2%. The frequencies of the neurological symptoms were as follows headaches in 32.8%, localized numbness in 5.2%, seizure in 1.7%, paresthesia in 3.4%, diffuse nonfocal symptoms in 1.7% (Figure 1). The total frequency of neurological involvement was 24.1% in SjS patients. Peripheral nervous system involvement in 8.6%. The findings of the magnetic resonans imaging of the patient with neurological involvement were as non-spesific gliotic lesions in 21.4%, periventricular lesions in 28.6%, paranchymal vasculitic lesions in 35.7%, multiple sclerosis-like plaques in 14.3%. There was found that anti-Ro positivity in 58.6%, anti-La in 19.2%, RF in 51.7%, ANA in 48.3%, low complement levels in 15.5%. However, anti-Ro positivity was lower in patient with neurological involvement than in patient without neurological involvement (p=0.025).
Conclusions The neurological involvement should be kept in mind when the patient has been diagnosed as SjS. It can be seen than it is expected. In addition, further studies need to be done to evaluate the role of anti-Ro autoantibody in SjS patients with neurological involvement.
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Acknowledgement We would like to thank to Ziynet Çınar, M.D. for her statistical analysis
Disclosure of Interest None declared