Search

Thirty-eight consecutive patients with primary Sjögren's syndrome (SS) and 36 with suspected (15 cases) or probable to definite (21 cases) multiple sclerosis (MS) underwent thorough neuropsychiatry and rheumatological examinations in order to detect either the presence of central neurologic involvement in SS or the presence of clinical and immunologic abnormalities typical of SS in MS. The only neuropsychiatric abnormality we found in patients first recorded for primary SS was major depression in 5 cases. On the other hand, one patient with suspected MS because of mild gait ataxia and right hemiparesis fulfilled the diagnostic criteria for SS. As for serologic tests, 6 out of 21 patients with probable to definite MS and 1 out of 15 with suspected MS had low-titre antinuclear antibodies. One patient with definite MS had also circulating anti-SSA/Ro antibodies, detected by gel double diffusion, but did not develop sicca symptoms after a 2-year follow-up. In the present study, the association between SS and MS was considerably weaker than that recently reported in other studies, and might be regarded as a chance finding.

We studied the levels of free plasma noradrenaline (norepinephrine, NE), adrenaline (epinephrine, E), and dopamine (DA) in 143 normal subjects, either basally or, in a part of them, in response to tour tests stimulating the sympathoadrenomedullary activity: the tilt-table test (TTT), the cold-pressor test (CPT), the mental-arithmetic test (MAT), and the insulin tolerance test (ITT). In both cases we evaluated the influence of age, which is considered the main physiological variable affecting the peripheral sympathetic activity. A normal distribution of values was observed, in the basal study, only for NE, while E and particularly, DA levels were distributed in an non-homogeneous fashion; a direct correlation was observed between age of subjects and NE levels, while neither E, nor DA levels showed any correlation with the aging process; sex did not influence any of the catecholamines.In the dynamic study, CPT, ITT and, above all, TTT elicited a significant rise in NE levels, while the E release was greatly stimulated by the insulin-induced hypoglycaemia. Neither NE, nor E levels rose after the MAT stimulation. Also in this case, the elderly showed an increased noradrenergic responsiveness when compared with the young subjects, confirming the existence of an 'up-regulation' of the peripheral sympathetic tone in old people.