A Case of Sjögren's Syndrome Mimicking Inflammatory Myopathy

Abstract

Sjögren's syndrome (SS) is a chronic autoimmune disorder, characterized by lymphocytic infiltration of exocrine glands and causing the decreased function of lacrimal and salivary glands. We describe a case of a 34-year-old male who presented with Sjögren's syndrome presenting as myopathy and sensorimotor neuropathy. His creatinine kinase levels were elevated with positive anti-Sjögren's syndrome-related antigen A autoantibodies and anti-Sjögren's syndrome Type B autoantibodies. Electromyography showed evidence of irritable myopathy. Parotid gland biopsy demonstrated focal lymphocytic sialadenitis. The patient favorably responded to high-dose steroids. Thus, although rare, inflammatory myopathy must be considered part of the initial presentation of Sjögren's syndrome.

Myasthenia Gravis with Idiopathic Inflammatory Myopathy and Sjögren Syndrome, A Triad of Immune-Mediated Diseases

“…In this case, the evolution of a patient with SS and IIM who developed myasthenic crisis due to the effect of increased doses of steroids was analyzed. This triple association was not found in the literature; instead, it has been reported that each of these immunemediated pathologies, such as SS and IIM, predominantly polymyositis, is difficult to diagnose [5,6]. The probability range of the inflammatory myopathy subtype using an online calculator was determined [7]; a score of 10.7 of the EULAR/ACR criteria was obtained [3].…”

“…Sjögren's syndrome (SS) is a chronic autoimmune disease accompanied by multiple lesions with main clinical manifestations, including dry mouth and eyes, together with systemic complications in various organs [4]. To date, there have been no reported instances of co-occurrence of the three diseases; however, a dual association between them has been reported [5], and some authors recommend that when such diseases coexist, more aggressive immunomodulatory treatments should be initiated. Herein, we present a case with three types of pathologies of immune-mediated origin: MG, IIM, and SS.…”

Limitations on the rights of migrant workers: Is a compliant and consistent approach being followed?

“…In my view the importance of providing access to social assistance to all who live permanently in South Africa and the impact upon life and dignity that a denial of such access has, far outweighs the financial and immigration considerations on which the state relies. 113 Notably, unlike the High Court which found that the right should be extended to all noncitizens, 114 the CC found that it may be reasonable to exclude migrants who have only a tenuous link to South Africa. It explained that the position of permanent residents was quite different to that of temporary or illegal residents.…”

“…107 The government's reliance on the benchmark set in developed countries was also discounted due to the wording of South Africa's Constitution, which provides everyone with the right to access social security. 108 Notwithstanding the CC's counter to these arguments, it was willing to assume that there was a rational connection between the citizenship provisions of the Social Assistance Act and the immigration policy it was said to support. 109 It moved on to determine whether the differentiation amounted to discrimination and whether it was unfair.…”

“…109 It moved on to determine whether the differentiation amounted to discrimination and whether it was unfair. 110 Relying on the decision of Larbi-Odam, it found, first, that the differentiation constituted discrimination 111 and, secondly that it was unfair, based on its impact on the human dignity of permanent residents. 112 The following pronouncements are noteworthy:…”