Research Article
Year 2021,
Volume: 43 Issue: 2, 152 - 158, 01.07.2021
Abstract
References
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- 4. Bayetto K, Logan RM (2010) Sjögren’s syndrome: a review of aetiology, pathogenesis, diagnosis and management. Australian Dental Journal (Suppl. 1): 39–47
- 5. Mavragani CP, Moutsopoulos HM (2010) The geoepidemiology of Sjögren’s syndrome. Autoimmunity Reviews 9(5): A305–10
- 6. Von Bultzinglowen I, Sollecito T, Fox P, et al. Salivary dysfunction associated with systemic diseases: systematic review and clinical management recommendations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103:S57.e1–15.
- 7. Ramos-Casals M, Tzioufas A, Font J. Primary Sjögren’s syndrome: new clinical and therapeutic concepts. Ann Rheum Dis2005;64:347–354.
- 8. Al-Hasimi I, Khuder S, Haghighat N, Zipp M. Frequency and predictive value of the clinical manifestations in Sjögren’s syndrome. J Oral Pathol Med 2001;301–306.
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- 14. Delalande S, de Seze J, Fauchalis AL, Hachulla E, Stojkovic T, Ferriby D, et al. Neurologic manifestations in primary Sjogren syndrome: a study of 82 patients. Medicine (Baltimore) 2004; 83(5):280-91
- 15. Ramos-Casals M, Solans R, Rosas J et al. Primary Sjögren syndrome in Spain: clinical and immunologic expression in 1010 patients. ; GEMESS Study Group. Medicine (Baltimore). 2008 Jul;87(4):210-9. doi: 10.1097/MD.0b013e318181e6af.
- 16. Massara A, Bonazza S, Castellino G et al Central nervous system involvement in Sjögren's syndrome: unusual, but not unremarkable--clinical, serological characteristics and outcomes in a large cohort of Italian patients.. Rheumatology (Oxford). 2010 Aug;49(8):1540-9.
- 17. Teixeira F, Moreira I, Silva AM,et al. Neurological involvement in Primary Sjögren Syndrome. Acta Reumatol Port. 2013 Jan-Mar;38(1):29-36.
- 18. Moreira I, Teixeira F, Martins Silva A et al Frequent involvement of central nervous system in primary Sjögren syndrome. Rheumatol Int. 2015 Feb;35(2):289-94. doi: 10.1007/s00296-014-3097-9.
- 19. Hoitsma E, Reulen JP, de Baets M et al . Small fiber neuropathy: a common and important clinical disorder. J Neurol Sci. 2004 Dec 15;227(1):119-30. Review.
- 20. Wingerchuk DM, Lennon VA, Lucchinetti CF, Pittock SJ, Weinshenker BG. The spectrum of neuromyelitis optica.Lancet Neurol. 2007 Sep;6(9):805-15. Review.
The relationship between anti-Ro autoantibody positivity and the frequency of neurological involvement in Sjögren’s syndrome
Abstract
Objective: The aim of this study is to investigate the frequency of neurological and other involvement patterns of the Primary Sjögren’s syndrome (pSS).
Method: Between June 2015 and January 2017, sixty SJS patients who were being followed up at Cumhuriyet University Medical Faculty Rheumatology-Internal Medicine Department were evaluated in the study. Their clinical complaints, glandular and extra-glandular findings, age, sex, other epidemiological data, Antinuclear antibody (ANA), Rheumatoid factor (RF), anti-Ro/La, Complemans (C3, C4), IgG, IgA, IgM levels were recorded.
Results: The mean age of the patients was 47.7±1.3 years, and the mean age at diagnosis was 47.1±1.6 years. Of the SS patients, fifty-nine (98.3%) were female and one (1.7%) was male. The frequencies of the clinical symptoms were as follows: arthralgia in 81.7%, arthritis in 46.7%, and biopsy-proven vasculitic lesions in 5%. The frequencies of the neurological symptoms were as follows: headache in 68.75%, localized numbness in 6.25%, seizure in 6.25%, paresthesia in 12.5%, and loss of function in 6.25% (Figure 1). The total frequency of neurological involvement was 26.7 % in SjS patients. Peripheral nervous system involvement was seen in 8.3%. The findings of the magnetic resonance imaging of the patients with neurological involvement were non-specific gliotic lesions in 25%, periventricular lesions in 31.25%, parenchymal vasculitic lesions in 31.25%, and multiple sclerosis-like plaques in 12.5%. Anti-Ro positivity was found in 58.3%, RF in 53.3%, ANA in 78.3%, and low complement levels in 15%. However, anti-Ro positivity was lower in patients with neurological involvement than in patients without neurological involvement (p= 0.025).
Conclusions: Neurological involvement should be kept in mind in patients diagnosed with SS. It can be seen more commonly than expected. In addition, further studies are needed to evaluate the mysterious role of anti-Ro autoantibody in SS patients with neurological involvement.
Thanks
We would like to thank to Ziynet Çınar, M.D. for her statistical analysis.
References
- 1. Mavragani CP, Moutsopoulos HM. Sjogren syndrome. CMAJ 2014 Oct 21;186(15):E579-86. doi: 10.1503/cmaj.122037. Epub 2014 Feb 24.
- 2. Soliotis FC, Mavragani CP, Moutsopoulos HM. Central nervous system involvement in Sjogren's syndrome. Ann Rheum Dis 2004 Jun;63(6):616-20.
- 3. Kassan SS, Moutsopoulos HM (2004) Clinical manifestations and early diagnosis of Sjögren syndrome. Archives of Internal Medicine 164(12): 1275–84
- 4. Bayetto K, Logan RM (2010) Sjögren’s syndrome: a review of aetiology, pathogenesis, diagnosis and management. Australian Dental Journal (Suppl. 1): 39–47
- 5. Mavragani CP, Moutsopoulos HM (2010) The geoepidemiology of Sjögren’s syndrome. Autoimmunity Reviews 9(5): A305–10
- 6. Von Bultzinglowen I, Sollecito T, Fox P, et al. Salivary dysfunction associated with systemic diseases: systematic review and clinical management recommendations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103:S57.e1–15.
- 7. Ramos-Casals M, Tzioufas A, Font J. Primary Sjögren’s syndrome: new clinical and therapeutic concepts. Ann Rheum Dis2005;64:347–354.
- 8. Al-Hasimi I, Khuder S, Haghighat N, Zipp M. Frequency and predictive value of the clinical manifestations in Sjögren’s syndrome. J Oral Pathol Med 2001;301–306.
- 9. Skopouli F, Dafni U, Ioannidis J, Moutsopoulos H. Clinical evolution, and morbidity and mortality of primary Sjögren’s syndrome. Semin Arthritis Rheum 2000;29:296–304.
- 10. Chai J, Logigian E. Neurological manifestations of primary Sjogren’s syndrome. Current Opinion in Neurology 2010, 23:509–511.
- 11. Vitali C, Bombardieri S, Jonsson R, et al. Classification criteria for Sjogren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis 2002; 61:554–558
- 12. Bamford J, Sandercock P, Dennis M, et al A prospective study of acute cerebrovascular disease in the community. J Neurol Neurosurg Psychiatry. 1988;51:1373–1380 5. Bamford JM Sandercock PAG et al. Letter to the Editor:
- 13. Gono T, Kawaguchi Y, Katsumata Y et al. Clinical manifestations of neurological involvement in primary Sjögren’s syndrome. Clin Rheumatol 2011; 30:485–490.
- 14. Delalande S, de Seze J, Fauchalis AL, Hachulla E, Stojkovic T, Ferriby D, et al. Neurologic manifestations in primary Sjogren syndrome: a study of 82 patients. Medicine (Baltimore) 2004; 83(5):280-91
- 15. Ramos-Casals M, Solans R, Rosas J et al. Primary Sjögren syndrome in Spain: clinical and immunologic expression in 1010 patients. ; GEMESS Study Group. Medicine (Baltimore). 2008 Jul;87(4):210-9. doi: 10.1097/MD.0b013e318181e6af.
- 16. Massara A, Bonazza S, Castellino G et al Central nervous system involvement in Sjögren's syndrome: unusual, but not unremarkable--clinical, serological characteristics and outcomes in a large cohort of Italian patients.. Rheumatology (Oxford). 2010 Aug;49(8):1540-9.
- 17. Teixeira F, Moreira I, Silva AM,et al. Neurological involvement in Primary Sjögren Syndrome. Acta Reumatol Port. 2013 Jan-Mar;38(1):29-36.
- 18. Moreira I, Teixeira F, Martins Silva A et al Frequent involvement of central nervous system in primary Sjögren syndrome. Rheumatol Int. 2015 Feb;35(2):289-94. doi: 10.1007/s00296-014-3097-9.
- 19. Hoitsma E, Reulen JP, de Baets M et al . Small fiber neuropathy: a common and important clinical disorder. J Neurol Sci. 2004 Dec 15;227(1):119-30. Review.
- 20. Wingerchuk DM, Lennon VA, Lucchinetti CF, Pittock SJ, Weinshenker BG. The spectrum of neuromyelitis optica.Lancet Neurol. 2007 Sep;6(9):805-15. Review.
There are 20 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Medical Science Research Articles |
| Authors | |
| Publication Date | July 1, 2021 |
| Acceptance Date | June 21, 2021 |
| Published in Issue | Year 2021Volume: 43 Issue: 2 |