Khalayli Naram, Kudsi Maysoun
Damascus University, Syrian Arab Republic.
Ann Med Surg (Lond). 2022 Jul 31;80:104243. doi: 10.1016/j.amsu.2022.104243. eCollection 2022 Aug.
Sjögren's syndrome is an autoimmune disease affecting exocrine glands and other organs. At the onset of the disease and during its course, it most commonly manifests as neuropsychiatric symptoms, most frequently, depression and anxiety. However, the association with bipolar disorder seems rare and not frequently documented.
Our case report presents a 43-year-old male complaining from neuropsychiatric symptoms including but not limited to periods of elevated mood, increased energy, headaches. Examination revealed xerophthalmia and xerostomia, thus Sjogren's Syndrome was diagnosed. A psychiatric consultation further diagnosed the patient with Bipolar Disorder. Successful treatment consisted of Carbamazepine and Azathioprine.
People with immunological diseases like Sjogren's Syndrome have a higher chance of developing Bipolar Disorder with an unclear etiology. Clinical symptoms, MRI findings, and cerebral fluid analysis can lead to a proper diagnosis. Treatments include usual treatment for Sjogren's such as corticosteroids and immunosuppressants, in the addition of mood stabilizers for Bipolar.
Psychiatry assessments should be done systematically in patients with autoimmune diseases to avoid delays in diagnosis and to make better treatment decisions.
干燥综合征是一种影响外分泌腺及其他器官的自身免疫性疾病。在疾病发作期及病程中，其最常见的表现为神经精神症状，最常见的是抑郁和焦虑。然而，与双相情感障碍的关联似乎罕见且记录不多。
我们的病例报告介绍了一名43岁男性，他主诉有神经精神症状，包括但不限于情绪高涨、精力增加、头痛。检查发现干眼症和口干症，因此诊断为干燥综合征。精神科会诊进一步诊断该患者患有双相情感障碍。成功的治疗方案包括卡马西平和硫唑嘌呤。
患有干燥综合征等免疫性疾病的人患双相情感障碍的几率更高，病因尚不清楚。临床症状、磁共振成像（MRI）结果和脑脊液分析有助于做出正确诊断。治疗包括干燥综合征的常规治疗，如皮质类固醇和免疫抑制剂，此外还需使用双相情感障碍的心境稳定剂。
对于自身免疫性疾病患者应系统地进行精神科评估，以避免诊断延误并做出更好的治疗决策。
