title: Acute transverse myelitis and psoriasiform dermatitis associated with Sjoegren's syndrome: a case report.
abstract: BACKGROUND
  Clinical complications of Sjoegren's syndrome include myelitis and skin manifestations. There is scarce observational data and a lack of randomised controlled studies regarding the treatment of Sjoegren's syndrome in the presence of such complications.
  
  
  METHODS
  Here we report the case of a 41-year-old Caucasian female patient with biopsy-proven Sjoegren's syndrome who initially presented with generalized exanthema and subsequently developed acute extensive transverse myelitis. In view of the rapid deterioration we opted for an intensive treatment using a combination of corticosteroid pulse therapy, plasmapheresis and cyclophosphamide, which we later changed to rituximab. Under that treatment the skin manifestations resolved entirely whereas transverse myelitis showed incomplete remission.
  
  
  CONCLUSIONS
  Severe neurological and dermatological complications may occur in Sjoegren's syndrome. This suggests a close yet currently unclear pathogenetic relationship. Intensive immunosuppressant treatment resulted in significant improvement of both symptom clusters. Skin manifestations may precede other severe complications in Sjoegren's syndrome and therefore require particular attention.
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technische Universität, Ismaninger Strasse 22, Munich 81675, Germany. kurz@lrz.tum.de.
authors.forename: Carolin
authors.initials: C
authors.lastname: Kurz
authors.forename: Silke
authors.initials: S
authors.lastname: Wunderlich
authors.forename: Derek
authors.initials: D
authors.lastname: Spieler
authors.forename: Benedikt J
authors.initials: BJ
authors.lastname: Schwaiger
authors.forename: Christian
authors.initials: C
authors.lastname: Andres
authors.forename: Claudia
authors.initials: C
authors.lastname: Traidl-Hoffmann
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Ilg
mesh_terms: D000328:Adult; D003872:Dermatitis / Q000150:complications*; D005260:Female; D006801:Humans; D009188:Myelitis, Transverse / Q000150:complications*; D011565:Psoriasis / Q000150:complications*; D012859:Sjogren's Syndrome / Q000150:complications*