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Characterisation of ataxia in Sjogren’s syndrome
  1. Cristina Saade Jaques1,
  2. Marianna Pinheiro Moraes de Moraes1,
  3. Eduardo Antonio Roquim Silva2,
  4. Antônio Rodrigues Coimbra-Neto3,
  5. Alberto R M Martinez3,
  6. Sarah Teixeira Camargos2,
  7. Francisco Cardoso2,
  8. Marcondes C França3,
  9. Anamarli Nucci3,
  10. Jose Luiz Pedroso1,
  11. Orlando G P Barsottini1
  1. 1 Department of Neurology, Division of General Neurology and Ataxia Unit, Universidade Federal de São Paulo—Campus São Paulo, São Paulo, Brazil
  2. 2 Department of Neurology, Universidade Federal de Minas Gerais Faculdade de Medicina, Belo Horizonte, Brazil
  3. 3 Department of Neurology, Universidade Estadual de Campinas Faculdade de Ciencias Medicas, Campinas, Brazil
  1. Correspondence to Dr Jose Luiz Pedroso, Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo - Campus São Paulo, Sao Paulo 04025011, Brazil; jlpedroso.neuro{at}gmail.com

http://dx.doi.org/10.1136/jnnp-2019-322373

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    Introduction

    Sjogren’s syndrome is a chronic autoimmune disorder characterised by lymphocytic infiltration of exocrine glands that causes dysfunction in salivary and lacrimal glands.1 Clinical features include dry eyes, dry mouth, fatigue, muscle pain and swelling, in association with the production of serum autoantibodies.1

    The neurological manifestations of Sjogren’s syndrome reach up to 70% of these patients and include peripheral neuropathy, aseptic meningitis, vasculitis, seizures, myelitis, cognitive dysfunction, optic neuropathies, parkinsonism and others.1 The most common neurological manifestations are characterised by axonal neuropathy, sensory neuronopathy and small fibre neuropathy.1

    On the other hand, ataxias are a heterogeneous group of diseases that comprise genetic and non-genetic aetiologies. The non-genetic or sporadic ataxias are frequently related to autoimmune disorders.2 However, cerebellar ataxia is rarely described in Sjogren’s syndrome. It is mandatory to classify ataxia as related to cerebellar damage (cerebellar ataxia) or to peripheral neuropathy (sensory ataxia). Usually, patients with Sjogren’s syndrome may present with sensory ataxia related to a sensory neuronopathy.2

    This study aimed to characterise the pattern of ataxia in Sjogren’s syndrome and also to describe cerebellar ataxia and cerebellar atrophy in some of these patients.

    Methods

    Fourteen patients with confirmed Sjogren’s syndrome and ataxia were enrolled on this study. All patients fulfilled criteria for primary Sjogren’s syndrome according to the American-European Consensus Group, 2002 and underwent clinical evaluation. Complementary tests included serum autoantibodies Ro (SSA) and …

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    Footnotes

    • Twitter @stcamargos, @Dr.

    • Contributors CSJ: planned, organised and executed the study. Evaluated patients, wrote and submitted this work. MPMdM: organised the study. EARS: evaluated patients. ARC-N: evaluated patients. ARMM: evaluated patients, reviewed and critiqued the survey. STC: reviewed and critiqued the survey. FC: evaluated patients, reviewed and critiqued the survey. MCF: reviewed and critiqued the survey. AN: reviewed and critiqued the survey. JLP: conceived, planned and organised, reviewed and critiqued the survey. OGPB: conceived, planned and organised, reviewed and critiqued the survey.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Ethics approval This study was approved by our Ethics Institution.

    • Provenance and peer review Not commissioned; externally peer reviewed.