Lopate Glenn, Pestronk Alan, Al-Lozi Muhammad, Lynch Timothy, Florence Julaine, Miller Timothy, Levine Todd, Rampy Tom, Beson Brent, Ramneantu Irena
Department of Neurology Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA.
Muscle Nerve. 2006 May;33(5):672-6. doi: 10.1002/mus.20514.
Peripheral neuropathy is common in patients with Sjögren's syndrome (SS), but its precise prevalence is unknown. Most prior studies were conducted at neurology or rheumatology specialty clinics and likely selected for a more severely affected population. We evaluated 22 SS patients and 10 controls for evidence of neuropathy in an outpatient setting at a regional meeting of the Sjögren's Syndrome Foundation. We performed neurological examinations and nerve conduction studies (NCSs) and measured serum antinuclear antibody (ANA) and SS-A and SS-B antibody levels. Participants filled out a questionnaire pertaining to symptoms, diagnosis, and treatment. We found that signs and symptoms related to small axons were more common in patients with SS than in controls. Complaints of painful distal paresthesias in the feet were noted in 59% of patients but in only 10% of controls, and of abnormal sweating in 41% and 0%, respectively. Examination revealed decreased pinprick sensation in 64% of patients with SS, but in only 30% of controls. Overall, 45% of the patients but none of the controls were thought to have an isolated small-fiber neuropathy. Large-fiber dysfunction (as measured by testing vibration, deep tendon reflexes, and NCSs) was similar between the two groups. We conclude that small-fiber neuropathy is common in patients with SS.
周围神经病变在干燥综合征（SS）患者中很常见，但其确切患病率尚不清楚。大多数先前的研究是在神经病学或风湿病专科诊所进行的，可能选择的是病情更严重的人群。在干燥综合征基金会的一次地区会议的门诊环境中，我们评估了22例SS患者和10例对照者的神经病变证据。我们进行了神经检查和神经传导研究（NCS），并测量了血清抗核抗体（ANA）以及SS - A和SS - B抗体水平。参与者填写了一份有关症状、诊断和治疗的问卷。我们发现，与小轴突相关的体征和症状在SS患者中比在对照者中更常见。59%的患者有足部疼痛性远端感觉异常的主诉，而对照者中只有10%有；异常出汗的主诉分别为41%和0%。检查发现，64%的SS患者针刺觉减退，而对照者中只有30%有。总体而言，45%的患者被认为患有孤立性小纤维神经病变，而对照者均无。两组之间大纤维功能障碍（通过测试振动、深腱反射和NCS来衡量）相似。我们得出结论，小纤维神经病变在SS患者中很常见。
