title: Immunological profiles determine neurological involvement in Sjögren's syndrome.
abstract: BACKGROUND
  Up to 68% of patients with primary Sjögren's syndrome (pSS) undergo neurological complications, and evidence for distinct immunological subgroups is emerging. We sought to determine systemic and immunological profiles associated with neurological manifestations.
  
  
  METHODS
  420 patients fulfilling the 2002 American-European pSS criteria were retrospectively analyzed. Neurological manifestations were diagnosed through clinical, biological, electrophysiological, and imaging findings. Biographical, clinical, and laboratory data were compared.
  
  
  RESULTS
  Within 93 (22%) patients with neurological manifestations, peripheral and central nervous systems were involved in 66% and 44%, respectively. Raynaud's phenomenon, cutaneous vasculitis, renal involvement, and cryoglobulinemia were associated with sensorimotor neuropathy and mononeuritis multiplex (p<0.05). Conversely, pure sensory neuropathy occurred without extraglandular manifestation, and without anti-Ro/SSA antibodies (p<0.05). All neurological manifestations were associated with increased use of corticosteroids and immunosuppressive drugs (p<0.05).
  
  
  CONCLUSIONS
  In pSS, patients with sensorimotor neuropathies and pure sensory neuropathies have distinct extraglandular and immunological profiles.
authors.affiliation: Department of Internal Medicine, Limoges University Hospital, Limoges F-87042, France; EA 3842 - Department of Immunology, Limoges University, Limoges F-87042, France. Electronic address: yvanjamilloux@hotmail.com.
authors.forename: Yvan
authors.initials: Y
authors.lastname: Jamilloux
authors.affiliation: Department of Neurology, Limoges University Hospital, Limoges F-87042, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Magy
authors.affiliation: Department of Neurology, Lille University Hospital, Lille F-59037, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Hurtevent
authors.affiliation: Department of Internal Medicine, Limoges University Hospital, Limoges F-87042, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Gondran
authors.affiliation: Department of Neurology, Strasbourg University Hospital, Strasbourg F-67091, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: de Seze
authors.affiliation: Department of Internal Medicine, Lille University Hospital, Lille F-59037, France.
authors.forename: David
authors.initials: D
authors.lastname: Launay
authors.affiliation: Department of Internal Medicine, Limoges University Hospital, Limoges F-87042, France.
authors.forename: Kim H
authors.initials: KH
authors.lastname: Ly
authors.affiliation: Department of Internal Medicine, Lille University Hospital, Lille F-59037, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Lambert
authors.affiliation: Department of Internal Medicine, Lille University Hospital, Lille F-59037, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Hachulla
authors.affiliation: Department of Internal Medicine, Lille University Hospital, Lille F-59037, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Hatron
authors.affiliation: Department of Internal Medicine, Limoges University Hospital, Limoges F-87042, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Vidal
authors.affiliation: Department of Internal Medicine, Limoges University Hospital, Limoges F-87042, France; EA 3842 - Department of Immunology, Limoges University, Limoges F-87042, France.
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Fauchais
mesh_terms: D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000276:immunology*; D002493:Central Nervous System Diseases / Q000209:etiology / Q000276:immunology*; D015331:Cohort Studies; D003449:Cryoglobulinemia; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology / Q000276:immunology; D008297:Male; D008875:Middle Aged; D020422:Mononeuropathies / Q000209:etiology / Q000276:immunology; D016472:Motor Neuron Disease / Q000209:etiology / Q000276:immunology; D010523:Peripheral Nervous System Diseases / Q000209:etiology / Q000276:immunology*; D011128:Polyradiculopathy / Q000209:etiology / Q000276:immunology; D016016:Proportional Hazards Models; D011928:Raynaud Disease / Q000209:etiology / Q000276:immunology; D012189:Retrospective Studies; D012217:Rheumatoid Factor / Q000276:immunology*; D012859:Sjogren's Syndrome / Q000150:complications / Q000276:immunology* / Q000503:physiopathology; D020886:Somatosensory Disorders / Q000209:etiology / Q000276:immunology; D014657:Vasculitis / Q000209:etiology / Q000276:immunology
chemical_list: D000974:Antibodies, Antinuclear; C035356:SS-A antibodies; C035357:SS-B antibodies; D012217:Rheumatoid Factor
keywords: Anti-SSA antibodies; Neurological manifestations; Neuronopathy; Primary Sjögren's syndrome