Progressive myelopathy revealing primary Sjogren syndrome: a case report
- Journal of Neurology & Stroke
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Yassine El Adraoui,1 Mohamed Hamid,1 Houda Alloussi,1 Youssouf Benmoh,1 Amal Satte,2 Ahmed Bourazza1
Abstract
1.1. Background: Central nervous system (CNS) involvement in primary
Sjogren Syndrome (pSS) is infrequent and often poses a diagnostic dilemma due
to its diverse clinical presentation.
1.2. Case presentation: A 66-year-old woman presented
to our department with a three-month history of progressive weakness in the
lower limbs, sensory loss, and sphincter dysfunction. Spine MRI revealed an
intramedullary hyperintense signal on T2 weighted images extending
longitudinally and transversally from D6 to D12. Auto-immune tests, viral
serologies, and metabolic workups yielded negative results. A minor salivary
gland biopsy confirmed chronic grade III sialadenitis. Primary Sjogren Syndrome
was diagnosed based on the 2016 ACR-EULAR classification criteria. The patient
underwent treatment with glucocorticoids and cyclophosphamide, showing mild
improvement after six months.
1.3. Conclusion: This case highlights the significance of considering
Sjogren syndrome in the differential diagnosis of progressive myelopathy. Given
the severity of spinal involvement in pSS, early diagnosis and aggressive
treatment from the disease’s onset are crucial.
Keywords
progressive myelopathy, central nervous system, sicca symptoms, primary sjögren syndrome, cyclophosphamide