1. Case of primary Sjogren's syndrome preceded by dystonia.
- Author
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Ararat K, Berrios I, Hannoun A, and Ionete C
- Subjects
- Adult, Antibodies, Antinuclear immunology, Dystonia etiology, Dystonia immunology, Female, Humans, Immunosuppressive Agents therapeutic use, Migraine Disorders diagnosis, Migraine Disorders etiology, Migraine Disorders immunology, Neuralgia diagnosis, Neuralgia etiology, Neuralgia immunology, Primary Dysautonomias diagnosis, Primary Dysautonomias etiology, Primary Dysautonomias immunology, Raynaud Disease diagnosis, Raynaud Disease etiology, Raynaud Disease immunology, Salivary Glands, Minor pathology, Sensation Disorders diagnosis, Sensation Disorders etiology, Sensation Disorders immunology, Sjogren's Syndrome complications, Sjogren's Syndrome drug therapy, Sjogren's Syndrome immunology, Syncope diagnosis, Syncope etiology, Syncope immunology, Urinary Bladder, Neurogenic diagnosis, Urinary Bladder, Neurogenic etiology, Urinary Bladder, Neurogenic immunology, Dystonia diagnosis, Sjogren's Syndrome diagnosis
- Abstract
There are only six cases in literature that describe development of dystonia with Sjogren's syndrome (SS). We describe a case of a 43-year-old woman who presented with symptoms including movement disorder, sensory neurogenic bladder, sensory loss and neuropathic pain, migraine like headaches, musculoskeletal pain, Raynaud's phenomenon and dysautonomia. Symptoms started in 2000, with weakness that progressed to dystonia in 2003. Diagnostic work-up was inconclusive with negative inflammatory serologies, cerebrospinal fluid and MRI for many years. After patient developed sicca syndrome with dry eyes and mouth in 2009, her rheumatoid factor titre was elevated (550 IU/mL), erythrocyte sedimentation rate, anti-Sjogrens syndrome-related antigen A (anti-Ro/SSA) and anti-SSB/La: anti-Sjogrens syndrome-related antigen B (anti-La/SSB) became positive. Lip biopsy confirmed diagnosis of SS. She was diagnosed with primary SS with neurological involvement. Her symptoms responded well to intravenous methylprednisolone. Symptoms stabilised with trials of immune-suppressive therapy. This is a case that demonstrates the delay of diagnosing SS with preceding unique neurological association., Competing Interests: Competing interests: CI: Biogen Idec and Genzyme. She has received compensations for consulting and advisory boards from Genzyme and TEVA. IB has received compensation for consulting in advisory board from Genzyme., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
- Published
- 2018
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