Font J, Valls J, Cervera R, Pou A, Ingelmo M, Graus F
Department of Internal Medicine, Hospital Clinic, Barcelona, Spain.
Ann Rheum Dis. 1990 Oct;49(10):775-8. doi: 10.1136/ard.49.10.775.
A pure sensory neuropathy caused by lymphocytic infiltration of the dorsal root ganglia has been reported in a few patients with Sjögren's syndrome. The clinical, immunological, and electromyographic findings of five patients with this type of neuropathy and primary Sjögren's syndrome were reviewed. Typical clinical indications were the presence of a chronic asymmetrical sensory deficit, initial disease in the hands with a predominant loss of the vibratory and joint position senses, and an association with Adie's pupil syndrome or trigeminal sensory neuropathy. The simultaneous impairment of the central and peripheral evoked cortical potentials suggested that there was a lesion of the neuronal cell body. The neuropathy preceded the diagnosis of Sjögren's syndrome in four patients. Four patients were positive for Ro antibodies, but systemic vasculitis or malignancy was not found after a mean follow up of six years. These findings indicate that in patients with a sensory neuropathy the diagnosis of Sjögren's syndrome has to be considered, even if the patient denies the presence of sicca symptoms, and that appropriate tests must be carried out.
少数干燥综合征患者曾报告出现由背根神经节淋巴细胞浸润引起的纯感觉性神经病。回顾了5例患有此类神经病及原发性干燥综合征患者的临床、免疫学和肌电图检查结果。典型的临床指征包括存在慢性不对称感觉障碍、手部起病且以振动觉和关节位置觉丧失为主,以及与阿-罗瞳孔综合征或三叉神经感觉神经病相关。中枢和外周诱发皮质电位同时受损提示神经元细胞体存在病变。4例患者的神经病在干燥综合征诊断之前出现。4例患者Ro抗体呈阳性,但平均随访6年后未发现系统性血管炎或恶性肿瘤。这些发现表明,即使患者否认存在干燥症状,对于感觉性神经病患者也必须考虑干燥综合征的诊断,并且必须进行适当检查。