Cerebellar degeneration in primary Sjӧgren syndrome

BMJ Case Rep. 2018 Jun 6:2018:bcr2017223952. doi: 10.1136/bcr-2017-223952.

Abstract

Neurological manifestations are reported as a consequence of primary Sjӧgren syndrome (PSS). Any part of the brain and peripheral nervous system can be involved in PSS. However, cerebellar degeneration and atrophy associated with PSS have been rarely reported. Our report describes a 22-year-old woman who presented with cerebellar ataxia, arthritis and arthralgia. Evaluation of her symptoms, autoantibodies and salivary gland pathology was in favour of the diagnosis of Sjögren syndrome. Also, her brain MRI revealed cerebellar degeneration. There are only four patients reported to be affected by cerebellar atrophy associated with PSS. Administration of high doses of methylprednisolone and cyclophosphamide leads to substantial improvement in the cerebellar symptoms of this case. In addition, after 2 months of follow-up, the patient's ataxia recovered significantly. It could be concluded that in addition to neurological degenerative disorders, in some cases cerebellar atrophy could also be associated with autoimmune conditions such as PSS.

Keywords: brain stem / cerebellum; movement disorders (other than parkinsons); sjogren’s syndrome.

Publication types

  • Case Reports

MeSH terms

  • Autoantibodies / analysis
  • Cyclophosphamide / therapeutic use*
  • Female
  • Gait Disorders, Neurologic / drug therapy
  • Gait Disorders, Neurologic / etiology
  • Gait Disorders, Neurologic / physiopathology*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Magnetic Resonance Imaging
  • Methylprednisolone / therapeutic use*
  • Neuroprotective Agents / therapeutic use*
  • Sjogren's Syndrome / complications
  • Sjogren's Syndrome / diagnosis*
  • Sjogren's Syndrome / drug therapy
  • Sjogren's Syndrome / physiopathology
  • Spinocerebellar Degenerations / diagnosis*
  • Spinocerebellar Degenerations / drug therapy
  • Spinocerebellar Degenerations / physiopathology
  • Treatment Outcome
  • Young Adult

Substances

  • Autoantibodies
  • Immunosuppressive Agents
  • Neuroprotective Agents
  • Cyclophosphamide
  • Methylprednisolone