title: [A case of Sjögren's syndrome with a high titer of anticardiolipin antibody that developed as parkinsonism].
abstract: A 50-year-old-male consulted us, complaining of gait disturbance. He was diagnosed as having Parkinson syndrome, but had no benefit of drugs for Parkinson disease. On admission he showed symptoms of parkinsonism such as parkinsonian gait, bradykinesia and muscle rigidity, and recurrent aseptic meningitis. Additionally, his condition was complicated by Sjögren's syndrome, based on the preliminary criteria of Sjögren's syndrome established by the European Community. Because his parkinsonism and meningitis were considered to be caused by Sjögren's syndrome, he was administered corticosteroids, which improved his parkinsonism and aseptic meningitis. The brain MR images in our case did not match those typically reported in cases of central nervous system Sjögren's syndrome (CNS-SS). Although the most common abnormalities are small distinct areas of increased signal intensity on T2-weighted images, the MR images in our case revealed periventricular diffuse areas of increased signal intensity on T2-weighted images. Although his parkinsonism and aseptic meningitis are believed to the effects of vasculitis caused by Sjögren's syndrome, it is also possible that his parkinsonism is related to Binswanger's disease resulting from a high titer of anticardiolipin antibody. Our report proposes a possible relationship between anticardiolipin antibody and CNS-SS when MR images reveal diffuse high intensity areas on T2-weighted images.
authors.affiliation: Third Department of Internal Medicine, National Defense Medical College.
authors.forename: H
authors.initials: H
authors.lastname: Mochizuki
authors.forename: M
authors.initials: M
authors.lastname: Okano
authors.forename: T
authors.initials: T
authors.lastname: Masaki
authors.forename: N
authors.initials: N
authors.lastname: Nagata
authors.forename: K
authors.initials: K
authors.lastname: Kamakura
mesh_terms: D017153:Antibodies, Anticardiolipin / Q000097:blood*; D001379:Azathioprine / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010302:Parkinson Disease, Secondary / Q000175:diagnosis / Q000209:etiology*; D011239:Prednisolone / Q000627:therapeutic use; D012859:Sjogren's Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D017153:Antibodies, Anticardiolipin; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D011239:Prednisolone; D001379:Azathioprine