Immunological profiles determine neurological involvement in Sjögren's syndrome

Eur J Intern Med. 2014 Feb;25(2):177-81. doi: 10.1016/j.ejim.2013.10.005. Epub 2013 Oct 29.

Abstract

Background: Up to 68% of patients with primary Sjögren's syndrome (pSS) undergo neurological complications, and evidence for distinct immunological subgroups is emerging. We sought to determine systemic and immunological profiles associated with neurological manifestations.

Methods: 420 patients fulfilling the 2002 American-European pSS criteria were retrospectively analyzed. Neurological manifestations were diagnosed through clinical, biological, electrophysiological, and imaging findings. Biographical, clinical, and laboratory data were compared.

Results: Within 93 (22%) patients with neurological manifestations, peripheral and central nervous systems were involved in 66% and 44%, respectively. Raynaud's phenomenon, cutaneous vasculitis, renal involvement, and cryoglobulinemia were associated with sensorimotor neuropathy and mononeuritis multiplex (p<0.05). Conversely, pure sensory neuropathy occurred without extraglandular manifestation, and without anti-Ro/SSA antibodies (p<0.05). All neurological manifestations were associated with increased use of corticosteroids and immunosuppressive drugs (p<0.05).

Conclusions: In pSS, patients with sensorimotor neuropathies and pure sensory neuropathies have distinct extraglandular and immunological profiles.

Keywords: Anti-SSA antibodies; Neurological manifestations; Neuronopathy; Primary Sjögren's syndrome.

MeSH terms

  • Adult
  • Aged
  • Antibodies, Antinuclear / immunology*
  • Central Nervous System Diseases / etiology
  • Central Nervous System Diseases / immunology*
  • Cohort Studies
  • Cryoglobulinemia
  • Female
  • Humans
  • Kidney Diseases / etiology
  • Kidney Diseases / immunology
  • Male
  • Middle Aged
  • Mononeuropathies / etiology
  • Mononeuropathies / immunology
  • Motor Neuron Disease / etiology
  • Motor Neuron Disease / immunology
  • Peripheral Nervous System Diseases / etiology
  • Peripheral Nervous System Diseases / immunology*
  • Polyradiculopathy / etiology
  • Polyradiculopathy / immunology
  • Proportional Hazards Models
  • Raynaud Disease / etiology
  • Raynaud Disease / immunology
  • Retrospective Studies
  • Rheumatoid Factor / immunology*
  • Sjogren's Syndrome / complications
  • Sjogren's Syndrome / immunology*
  • Sjogren's Syndrome / physiopathology
  • Somatosensory Disorders / etiology
  • Somatosensory Disorders / immunology
  • Vasculitis / etiology
  • Vasculitis / immunology

Substances

  • Antibodies, Antinuclear
  • SS-A antibodies
  • SS-B antibodies
  • Rheumatoid Factor