title: Parkinsonism and Sjögren's Syndrome: A Fortuitous Association or a Shared Immunopathogenesis?
abstract: Background. The Sjögren Syndrome (SS) can include various manifestations of central nervous system impairment. Extrapyramidal signs are known to be very rare and unusually discovered on early onset in this pathology. Observation. A 46-year-old woman with a history of progressive Parkinsonism for 6 years and a normal brain magnetic resonance imaging was partially improved with levodopa therapy. The later discovery of a sicca syndrome led to performing of further investigations, which revealed the presence of anti-SSA antibodies and a sialoadenitis of grade 4 according to Chisholm's classification on labial salivary gland biopsy. The diagnosis of primary SS was established and the adjunction of corticotherapy has remarkably improved Parkinson's signs without use of other immunosuppressive agents. Conclusion. Based on these findings, we discuss the hypothesis of either a causal link between SS and Parkinsonism or a fortuitous association of two distinct pathologies with or without a shared immunopathogenesis.
authors.affiliation: Neurological Department, Charles Nicolle Hospital, Boulevard du 9 Avril, Beb Souika, 1016 Tunis, Tunisia ; Faculty of Medicine of Tunis, Tunisia.
authors.forename: Mariem
authors.initials: M
authors.lastname: Kchaou
authors.affiliation: Neurological Department, Charles Nicolle Hospital, Boulevard du 9 Avril, Beb Souika, 1016 Tunis, Tunisia ; Faculty of Medicine of Tunis, Tunisia.
authors.forename: Nadia
authors.initials: N
authors.lastname: Ben Ali
authors.affiliation: Neurological Department, Charles Nicolle Hospital, Boulevard du 9 Avril, Beb Souika, 1016 Tunis, Tunisia.
authors.forename: Intissar
authors.initials: I
authors.lastname: Hmida
authors.affiliation: Neurological Department, Charles Nicolle Hospital, Boulevard du 9 Avril, Beb Souika, 1016 Tunis, Tunisia ; Faculty of Medicine of Tunis, Tunisia.
authors.forename: Saloua
authors.initials: S
authors.lastname: Fray
authors.affiliation: Neurological Department, Charles Nicolle Hospital, Boulevard du 9 Avril, Beb Souika, 1016 Tunis, Tunisia ; Faculty of Medicine of Tunis, Tunisia.
authors.forename: Hela
authors.initials: H
authors.lastname: Jamoussi
authors.affiliation: Neurological Department, Charles Nicolle Hospital, Boulevard du 9 Avril, Beb Souika, 1016 Tunis, Tunisia.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Jalleli
authors.affiliation: Neurological Department, Charles Nicolle Hospital, Boulevard du 9 Avril, Beb Souika, 1016 Tunis, Tunisia.
authors.forename: Slim
authors.initials: S
authors.lastname: Echebbi
authors.affiliation: Neurological Department, Charles Nicolle Hospital, Boulevard du 9 Avril, Beb Souika, 1016 Tunis, Tunisia ; El Manar University, Tunisia.
authors.forename: Afef
authors.initials: A
authors.lastname: Achouri
authors.affiliation: Neurological Department, Charles Nicolle Hospital, Boulevard du 9 Avril, Beb Souika, 1016 Tunis, Tunisia ; Faculty of Medicine of Tunis, Tunisia.
authors.forename: Samir
authors.initials: S
authors.lastname: Belal