Shchepankevich MS, Bogoderova LA, Veretelnikov IA, Taneeva EV, Korobko DS. The difficult way in diagnostics of neurological manifestations of Sjogren's disease. Case report. Consilium Medicum. 2023;25(11):751–754.
DOI: 10.26442/20751753.2023.11.202460
Трудный путь в диагностике неврологических проявлений болезни Шегрена
Щепанкевич М.С., Богодерова Л.А., Веретельников И.А., Танеева Е.В., Коробко Д.С. Трудный путь в диагностике неврологических проявлений болезни Шегрена. Consilium Medicum. 2023;25(11):751–754.
DOI: 10.26442/20751753.2023.11.202460
Shchepankevich MS, Bogoderova LA, Veretelnikov IA, Taneeva EV, Korobko DS. The difficult way in diagnostics of neurological manifestations of Sjogren's disease. Case report. Consilium Medicum. 2023;25(11):751–754.
DOI: 10.26442/20751753.2023.11.202460
Болезнь Шегрена (БШ) представляет собой иммуновоспалительное ревматическое заболевание, характеризующееся поражением секретирующих эпителиальных желез с развитием паренхиматозного сиалоаденита с ксеростомией и сухого кератоконъюнктивита с гиполакримией. Ввиду высокой гетерогенности клинических проявлений БШ затруднена постановка диагноза. В статье представлен клинический случай пациента с подробным описанием манифестации, течения и лечения БШ с редким сочетанием внежелезистых осложнений в виде полимиозита с вторичной полинейропатией.
Ключевые слова: болезнь Шегрена, полимиозит, вторичная полинейропатия, клинический случай
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Sjogren's disease is an immunoinflammatory rheumatic disease that is characterized by damage to the secreting epithelial glands with the development of parenchymal sialadenitis with xerostomia and keratoconjunctivitis sicca with hypolacrymia. Due to the high heterogeneity of clinical manifestations of this disease, diagnosis is difficult. This article presents a clinical case of a patient with a detailed description of the manifestation, course, and treatment of Sjogren's disease with a rare combination of extraglandular complications in the form of polymyositis and secondary polyneuropathy.
Keywords: Sjogren's disease, polymyositis, secondary polyneuropathy, clinical case
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13. Baldini C, Pepe P, Quartuccio L, et al. Primary Sjogren’s syndrome as a multi-organ disease: impact of the serological profile on the clinical presentation of the disease in a large cohort of Italian patients. Rheumatology (Oxford). 2014;53:839-44. DOI:10.1093/rheumatology/ket427
14. Rist S, Sellam J, Hachulla E, et al. Experience of intravenous immunoglobulin therapy in neuropathy associated with primary Sjogren's syndrome: a national multicentric retrospective study. Multicenter Study. Arthritis Care Res (Hoboken). 2011;63(9):1339-44. DOI:10.1002/acr.20495
15. Blinova VG, Vasilyev VI, Rodionova EB, Zhdanov DD. The role of regulatory T Cells in the onset and progression of primary Sjogren’s syndrome. Cells. 2023;12(10):1359. DOI:10.3390/cells12101359
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1. Panasiuk GD, Bobr TV. Bolezn' Shegrena v praktike vracha: prakticheskoe posobie dlia vrachei-oftal'mologov. Gomel: RNPTs RMiECh, 2020 (in Russian).
2. Elovikova TM, Grigor'ev SS. Sukhoi sindrom (sindrom Shegrena): proiavleniia v polosti rta: uchebnoe posobie. Ekaterinburg: TIRAZh, 2018 (in Russian).
3. Safonova TN, Vasil'ev VI. Sindrom Shegrena: rukovodstvo dlia vrachei. Moscow: Moskovskii gosudarstvennyi universitet, 2013 (in Russian).
4. Shiboski CH, Shiboski SC, Seror R, et al. 2016 American College of Rheumatology/European League Against Rheumatism classification criteria for primary Sjogren’s syndrome: a consensus and data-driven methodology involving three international patient cohorts. Arthritis Rheumatol. 2017;69(1):35-45. DOI:10.1002/art.39859
5. Alunno A, Carubbi F, Bartoloni E, et al. The kaleidoscope of neurological manifestations in primary Sjogren's syndrome. Clin Exp Rheumatol. 2019;118(3):192-8.
6. Levin OS. Polineiropatii. Klinicheskoe rukovodstvo. Moscow: Meditsinskoe informatsionnoe agentstvo, 2005 (in Russian).
7. Koike H, Sobue G. Sjogren's syndrome-associated neuropathy. Brain Nerve. 2013;65(11):1333-42.
8. Piradov MA, Suponeva NA, Grishina DA. Polineiropatii: algoritmy diagnostiki i lecheniia. Moscow: Goriachaia liniia – telekom, 2020 (in Russian).
9. Liampas A, Parperis K, Erotocritou MF, et al. Primary Sjogren syndrome-related peripheral neuropathy: a systematic review and meta-analysis. Eur J Neurol. 2023;30(1):255-65. DOI:10.1111/ene.15555
10. Ruiz-Lozano RE, Velazquez-Valenzuela F, Roman-Zamudio M, et al. Polymyositis and dermatomyositis: ocular manifestations and potential sight-threatening complications. Rheumatol Int. 2022;42(7):1119-31. DOI:10.1007/s00296-021-05035-7
11. Seeliger T, Kramer E, Konen FF, et al. Sjogren's syndrome with and without neurological involvement. J Neurol. 2023;270(6):2987-96. DOI:10.1007/s00415-023-11613-5
12. McCoy SS, Baer AN. Neurological complications of Sjogren’s syndrome: diagnosis and management. Curr Treatm Opt Rheumatol. 2017;3(4):275-88. DOI:10.1007/s40674-017-0076-9
13. Baldini C, Pepe P, Quartuccio L, et al. Primary Sjogren’s syndrome as a multi-organ disease: impact of the serological profile on the clinical presentation of the disease in a large cohort of Italian patients. Rheumatology (Oxford). 2014;53:839-44. DOI:10.1093/rheumatology/ket427
14. Rist S, Sellam J, Hachulla E, et al. Experience of intravenous immunoglobulin therapy in neuropathy associated with primary Sjogren's syndrome: a national multicentric retrospective study. Multicenter Study. Arthritis Care Res (Hoboken). 2011;63(9):1339-44. DOI:10.1002/acr.20495
15. Blinova VG, Vasilyev VI, Rodionova EB, Zhdanov DD. The role of regulatory T Cells in the onset and progression of primary Sjogren’s syndrome. Cells. 2023;12(10):1359. DOI:10.3390/cells12101359
1ФГБОУ ВО «Новосибирский государственный медицинский университет» Минздрава России, Новосибирск, Россия; 2ГБУЗ НСО «Государственная Новосибирская областная клиническая больница», Новосибирск, Россия
*mari.shchepankevich@mail.ru
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Maria S. Shchepankevich*1, Larisa A. Bogoderova2, Ivan A. Veretelnikov2, Elena V. Taneeva2, Denis S. Korobko1,2
1Novosibirsk State Medical University, Novosibirsk, Russia; 2State Novosibirsk Regional Clinical Hospital, Novosibirsk, Russia
*mari.shchepankevich@mail.ru