Fauchais Anne-Laure, Magy Laurent, Vidal Elisabeth
Limoges University Hospital, Internal Medicine Unit, 87042 Limoges, France.
Presse Med. 2012 Sep;41(9 Pt 2):e485-93. doi: 10.1016/j.lpm.2012.06.002. Epub 2012 Jul 26.
Primary Sjögren's syndrome (pSS) is an autoimmune inflammatory disorder characterized by lymphocytic infiltration of exocrine glands, mainly the lacrimal and salivary glands leading to a chronic sicca syndrome. However, extraglandular organ systems may frequently be involved, including both central and peripheral nervous systems. Clinically significant neurologic manifestations affect approximately 20% of patients and may be the first manifestation of the disease in at least 25% of the cases. The spectrum of pSS-related neuropathies is wide including sensory neuropathies, neuronopathies, sensory-motor neuropathies, mononeuritis multiplex related to vasculitis… Central nervous system involvement is composed by multiple sclerosis-like manifestations including acute and chronic myelopathies and by more diffuse manifestations (cognitive dysfunction, subacute aseptic meningitis, encephalopathy, psychiatric symptoms, chorea, seizures…). The diagnosis and treatment of such pSS-related manifestations must be optimized in order to avoid severe disability.
原发性干燥综合征(pSS)是一种自身免疫性炎症性疾病,其特征是外分泌腺,主要是泪腺和唾液腺出现淋巴细胞浸润,导致慢性干燥综合征。然而,腺外器官系统也常受累,包括中枢神经系统和周围神经系统。具有临床意义的神经表现影响约20%的患者,并且在至少25%的病例中可能是该疾病的首发表现。pSS相关神经病变的范围很广,包括感觉神经病变、神经元病变、感觉运动神经病变、与血管炎相关的多发性单神经炎……中枢神经系统受累表现为类似多发性硬化的症状,包括急性和慢性脊髓病,以及更弥漫性的症状(认知功能障碍、亚急性无菌性脑膜炎、脑病、精神症状、舞蹈病、癫痫发作……)。必须优化对此类pSS相关表现的诊断和治疗,以避免严重残疾。