Multipl Skleroz Benzeri Primer Sjögren Sendrom: Olgu Sunumu

Öz

Özet: 

Sjögren sendromu; santral sinir sistemi tutulum prevalansı net bilinmemekle birlikte klinik spektrumu olarak geniş bir yelpazeye sahiptir. Optik nöropati, serebeller ataksi, internükleer oftalmopleji ve piramidal tutulum gibi relaps ve remisyonlarla seyreden bazı klinik bulgular, beyin omurilik sıvısı özellikleri ve radyolojik görünümleri Multipl sklerozu (MS) taklit edebilir. Olguda, 27 yaşında kadın hastanın başağrısı, ağız kuruluğu ve sol tarafta uyuşma şikayeti mevcuttu. Sjögren sendromu tanısı konan hastanın klinik ve özellikle kranial MR bulguları multipl skleroz ile benzerdi. Multipl skleroz-benzeri-Sjögren sendromunda ayırıcı tanıda güçlükler nedeniyle bu vaka sunulmuştur. 

Anahtar Kelimeler

• Sjögren sendromu,Serebral tutulum,MS benzeri Sjögren sendromu

Multiple Sclerosis-Like-Primary Sjögren’s Syndrome: Case Report

Abstract

Sjögren’s syndrome; the prevalence of central neural system (CNS) involvement is not clear, but the clinical spectrum of CNS involvement is wide. Some clinical findings, including optic neuropathy, pyradimal involvement, cerebellar ataxia, internuclear ophthalmoplegia, frequently characterized by relapsing-remitting course, and cerebrospinal and radiological findings may simulate Multiple Sclerosis (MS). In our case, a 27-year old-female patient suffered from headache, left hemihypoestesia, and dryness of the mouth. In the patient, who was diagnosed with Sjögren syndrome, the clinical symptoms, and especially the cranial MRI findings were similar to those of MS. We presented the case report because of difficulties in differential diagnosis in a patient with MS-like-primary Sjögren syndrome.

Keywords

• Sjögren syndrome,cerebral involvement,MSlike-Sjögren syndrome

Kaynakça

1. 1- Vitali C, Bombardieri S, Jonsson R, Moutsopoulos HM, Alexander EL, Carsons SE, et al. Classification criteria for Sjo¨gren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis 2002; 61(6):554–8.
2. 2- Jonsson R, Moen K, Vestrheim D, Szodoray P.Current issues in Sjögren’s syndrome. Oral Dis 2002;8(3):130-40.
3. 3- Govoni M, Padovan M, Rizzo N, Trotta F. CNS involvement in primary Sjögren’s syndrome: prevalence, clinical aspects, diagnostic assessment and therapeutic approach. CNS Drugs 2001;15(8):597-607.
4. 4- Ackstein C, Saidha S, Levy M. A differential diagnosis of central nervous system demyelination: beyond multiple sclerosis. J Neurol 2012;259(5):801-16.
5. 5- Kurne A, Isikay IC, Karlioguz K, Kalyoncu U, Aydin OF, Calguneri M, et al. A clinically isolated syndrome: challenging entity: multiple sclerosis or collagen tissue disorders: clues for differentiation. J Neurol 2008;255(11):1625-35.
6. 6- Rampello L, Malaguarnera M, Rampello L, Nicoletti G, Battaglia G. Headach e in patients with autoimmune disorders. Clin Neurol Neurosurg 2012;114(6):751-3.
7. 7- Wise CM, Agudelo CA. Optic neuropathy as an initial manifestation of Sjögren’s syndrome. J Rheumatol 1988;15:799-802.
8. 8- Alexander EL, Malinow K, Lejewski JE, Jerdan MS, Provost TT, Alexander GE et al. Primary Sjögren’s syndrome with central nervous system disease mimicking multiple sclerosis. Ann Intern Med 1986;104(3):323-30.

9. 9- Alexander EL, Beall SS, Gordon B, Selnes OA, Yannakakis GD, Patronas N, et al. Magnetic resonance imaging of cerebral lesions in patients with the Sjögren syndrome. Ann Intern Med 1988;108(6):815-23.
10. 10- Coates T, Slavotinek JP, Rischmueller M, Schultz D, Anderson C, Dellamelva M, et al. Cerebral white matter lesions in primary Sjögren’s syndrome: a controlled study. J Rheumatol 1999;26(6):1301-5.
11. 11- Delalande S, de Seze J, Fauchais AL, Hachulla E, Stojkovic T, Ferriby D, et al. Neurologic manifestations in primary Sjögren syndrome: a study of 82 patients. Medicine (Baltimore) 2004;83(5):280-91.