title: Peripheral neuropathy in an outpatient cohort of patients with Sjögren's syndrome.
abstract: Peripheral neuropathy is common in patients with Sjögren's syndrome (SS), but its precise prevalence is unknown. Most prior studies were conducted at neurology or rheumatology specialty clinics and likely selected for a more severely affected population. We evaluated 22 SS patients and 10 controls for evidence of neuropathy in an outpatient setting at a regional meeting of the Sjögren's Syndrome Foundation. We performed neurological examinations and nerve conduction studies (NCSs) and measured serum antinuclear antibody (ANA) and SS-A and SS-B antibody levels. Participants filled out a questionnaire pertaining to symptoms, diagnosis, and treatment. We found that signs and symptoms related to small axons were more common in patients with SS than in controls. Complaints of painful distal paresthesias in the feet were noted in 59% of patients but in only 10% of controls, and of abnormal sweating in 41% and 0%, respectively. Examination revealed decreased pinprick sensation in 64% of patients with SS, but in only 30% of controls. Overall, 45% of the patients but none of the controls were thought to have an isolated small-fiber neuropathy. Large-fiber dysfunction (as measured by testing vibration, deep tendon reflexes, and NCSs) was similar between the two groups. We conclude that small-fiber neuropathy is common in patients with SS.
authors.affiliation: Department of Neurology Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA. lopateg@neuro.wustl.edu
authors.forename: Glenn
authors.initials: G
authors.lastname: Lopate
authors.forename: Alan
authors.initials: A
authors.lastname: Pestronk
authors.forename: Muhammad
authors.initials: M
authors.lastname: Al-Lozi
authors.forename: Timothy
authors.initials: T
authors.lastname: Lynch
authors.forename: Julaine
authors.initials: J
authors.lastname: Florence
authors.forename: Timothy
authors.initials: T
authors.lastname: Miller
authors.forename: Todd
authors.initials: T
authors.lastname: Levine
authors.forename: Tom
authors.initials: T
authors.lastname: Rampy
authors.forename: Brent
authors.initials: B
authors.lastname: Beson
authors.forename: Irena
authors.initials: I
authors.lastname: Ramneantu
mesh_terms: D000974:Antibodies, Antinuclear / Q000097:blood; D015331:Cohort Studies; D004568:Electrodiagnosis / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D009460:Neurologic Examination / Q000379:methods; D010045:Outpatients; D010523:Peripheral Nervous System Diseases / Q000150:complications* / Q000453:epidemiology*; D012859:Sjogren's Syndrome / Q000150:complications* / Q000453:epidemiology*; D011795:Surveys and Questionnaires
chemical_list: D000974:Antibodies, Antinuclear; C035356:SS-A antibodies; C035357:SS-B antibodies