[A case of Sjögren's syndrome with mononeuritis associated with high levels of circulating immune complexes].
A 32-year-old woman with Sjögren's syndrome accompanied by mononeuritis of right lower extremity was described. She admitted Shinshu University Hospital with the chief complaints of Raynaud's phenomenon and generalized lymphadenopathy. One year before admission Raynaud's phenomenon of right hand was first noticed. One month later she complained of a gritty sensation in the eyes and severe dryness of the mouth. On admission, she had systemic lymphadenopathy. Neurological examination revealed decreased light touch and pinprick sensations and decreased deep tendon reflexes in right lower extremity. Lip biopsy revealed marked mononuclear cell infiltrates around the salivary glands. Laboratory data included IgG 3,007 mg/dl, circulating immune complexes 1,200 micrograms AHGeq/ml (Raji-cell ELISA), anti-nuclear antibody 2,560X (speckled pattern) and anti-SSA antibody 256X. The levels of total protein, IgG and immune complexes were increased in the CSF of this patient. Sural nerve biopsy revealed a decreased number of large myelinated fibers and perivascular lymphocyte infiltration of vasa nervorum. Direct immunofluorescent staining showed deposition of IgG and C3 in the endoneural vessel walls. The increased level of immune complexes were decreased in the sera of the patient, accompanied by remission. These results suggest that immune complexes may be involved in the pathogenesis of a mononeuritis associated with Sjögren's syndrome.
Tanaka
Y
Y
Tsukada
N
N
Koh
C S
CS
Yanagisawa
N
N
D000328:Adult; D000936:Antigen-Antibody Complex / Q000032:analysis / Q000134:cerebrospinal fluid*; D005260:Female; D006801:Humans; D009443:Neuritis / Q000209:etiology* / Q000473:pathology; D012859:Sjogren's Syndrome / Q000209:etiology* / Q000473:pathology; D013497:Sural Nerve / Q000473:pathology
D000936:Antigen-Antibody Complex