CR66 Rare complications of Sjögren’s syndrome in a female patient.

INTRODUCTION/OBJECTIVES: Sjögren’s syndrome (SjS) is a systemic autoimmune disease, most common in middle-aged women, characterized by chronic inflammation of exocrine glands. It can present by itself or alongside other autoimmune diseases. Main symptoms are dry eyes and mouth, but the disease can affect joints, lungs, kidneys, peripheral nervous system (PNS), and rarely central nervous system (CNS). SS-A antibodies in SjS can pass the fetoplacental barrier and cause congenital heart block. Patients with SjS are at higher risk of developing lymphoma. CASE PRESENTATION: We present a case of a 40-year-old woman who was diagnosed with SjS in 2009, presenting with dry eyes and mouth, arthritis, alongside vasculitis i.e. purpura of the shins. She was treated with prednisone and chloroquine. In 2008 she gave birth to a child with complete atrioventricular block. Recently she complained of foot numbness without motor weakness. Now she was hospitalized due to symptoms of meningoencephalitis. Cerebrospinal fluid (CSF) analysis was positive for oligoclonal bands. CSF, urine, and blood cultures were sterile. MRI showed pathomorphological findings in cauda equina. Neuropathy of thin sensory and motor fibers was found on electromyoneurography. The patient was treated with antibiotics, methylprednisolone, intravenous immunoglobulins, and supportive measures. She recovered completely and azathioprine was introduced for maintaining remission. CONCLUSION: Overall nervous system manifestations are described in 20% of patients with primary SjS, but CNS manifestations are described rarely. Congenital heart block is described in 2% of the pregnancies in mothers with SS-A antibodies. With timely introduction of immunosuppressants the conditions are treatable and preventable. [ABSTRACT FROM AUTHOR]