[A case of motor dominant neuropathy and focal segmental glomerulosclerosis associated with Sjögren's syndrome].
A 49-year-old woman was admitted to our hospital with gradually progressive weakness of the limbs for about 20 days. She presented with weakness of the limbs, predominantly in the proximal portion, and slight dysesthesia of the limbs, predominantly in the distal portion. Repeated nerve conduction examination revealed axonopathy dominantly in the motor neurons. Therefore, we suspected her as having Guillain-Barré syndrome, and initiated intravenous administration of high-dose immunoglobulin. However, her symptoms progressed gradually and finally she found it difficult to walk. Her urine analysis simultaneously demonstrated albuminuria, and a kidney biopsy indicated focal segmental glomerulosclerosis. At that point, laboratory examination showed high levels of anti SS-A antibody and salivary gland biopsy revealed infiltration of a significant number of lymphocytes around the gland, which led to the diagnosis of Sjögren's syndrome. We considered the etiology of the neural and renal dysfunction as due to the inflammatory mechanism associated with Sjögren's syndrome. Therefore, we administered a second course of immunoglobulin therapy and steroid therapy, which included both pulse and oral administration. Her neurologic symptoms and albuminuria improved rapidly after steroid therapy. The present case indicates that both motor dominant neuropathy and focal segmental glomerulosclerosis can occur in patients with Sjögren's syndrome.
Department of Neurology and Stroke Treatment, Kyoto First Red Cross Hospital.
Atsushi
A
Yamamoto
Keisuke
K
Imai
Masashi
M
Hamanaka
Takehiro
T
Yamada
Hidekazu
H
Yamazaki
Kazuma
K
Tsuto
Yukiko
Y
Tsuji
Noriyuki
N
Yamashita
Masatoshi
M
Kadoya
D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000209:etiology*; D012859:Sjogren's Syndrome / Q000150:complications* / Q000188:drug therapy; D013256:Steroids / Q000627:therapeutic use
D013256:Steroids