Bilateral optic neuropathy revealing Sjögren's syndrome

Béjot, Yannick; Osseby, Guy‐Victor; Salem, Douraı̈ed Ben; Beynat, J.; Müller, G.; Moreau, Thibault; Giroud, M.

doi:10.1016/j.neurol.2008.04.017

Cited by 16 publications

(10 citation statements)

References 13 publications

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“…It is well known that it is closely linked with other systemic diseases including autoimmune diseases, Sjögren, myasthenia gravis or Hashimoto thyroiditis, infection, autoimmune-mediated vitamin B12 deficiency, and toxic exposure, which made some scientists to suggest that these infections or autoimmune diseases are the trigger for the onset of NMO, but a real pathophysiological association or etiology of NMO remains unknown 35–40…”

Section: Introductionmentioning

confidence: 99%

Systemic Lupus Erythematosus (SLE) Complicated by Neuromyelitis Optica (NMO – Devic's Disease): Clinic-Pathological Report and Review of the Literature

Adawi

Bisharat

Bowirrat

2014

Clin Med Insights Case Rep

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Neuromyelitis optica (NMO) is usually a relapsing demyelinating disease of the central nervous system associated with optic neuritis, transverse myelitis involving three or more contiguous spinal cord segments, and seropositivity for NMO-IgG antibody. NMO is often mistaken for multiple sclerosis and there are relatively sporadic publications about NMO and overlapping systemic or organ-specific autoimmune diseases, such as systemic lupus erythematosus (SLE). We described a unique case of a 25-year-old Arab young woman who was diagnosed with SLE, depending on clinical, laboratory investigations and after she had fulfilled the diagnostic criteria for SLE and had presented the following findings: constitutional findings (fatigue, fever, and arthralgia); dermatologic finding (photosensitivity and butterfly rash); chronic renal failure (proteinuria up to 400 mg in 24 hours); hematologic and antinuclear antibodies (positivity for antinuclear factor (ANF), anti-double-stranded DNA antibodies, direct Coombs, ANA and anti-DNA, low C4 and C3, aCL by IgG and IgM). Recently, she presented with several episodes of transverse myelitis and optic neuritis. Clinical, radiological, and laboratory findings especially seropositivity for NMO-IgG were compatible with NMO. Accurate diagnosis is critical to facilitate initiation of immunosuppressive therapy for attack prevention. This case illustrates that NMO may be associated with SLE.

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Section: Introductionmentioning

confidence: 99%

Systemic Lupus Erythematosus (SLE) Complicated by Neuromyelitis Optica (NMO – Devic's Disease): Clinic-Pathological Report and Review of the Literature

Adawi

Bisharat

Bowirrat

2014

Clin Med Insights Case Rep

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“…Furthermore, in recent studies bilateral ON combined with SLE/SS cases has been reported, and this tape of ON has been considered more likely combined with AQP-4 antibody or relapse to NMO. [6], [7]. ON with autoimmune diseases present a relapsing remitting clinical profile, or lack of response to the regular glucocorticoid treatment [8].…”

Section: Introductionmentioning

confidence: 99%

Frequency of Autoantibodies and Connective Tissue Diseases in Chinese Patients with Optic Neuritis

Zhang

et al. 2014

PLoS ONE

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BackgroundOptic neuritis (ON) is often associated with other clinical or serological markers of connective tissue diseases (CTDs). To date, the effects of autoantibodies on ON are not clear.PurposeTo assess the prevalence, clinical patterns, and short outcomes of autoantibodies and Sjögren’s syndrome (SS) involvement in Chinese ON patients and evaluate the relationship between ON, including their subtypes, and autoantibodies.MethodsA total of 190 ON patients were divided into recurrent ON (RON), bilateral ON (BON), and isolated monocular ON (ION). Demographic, clinical, and serum autoantibodies data were compared between them with and without SS involvement. Serum was drawn for antinuclear antibody (ANA), extractable nuclear antigen antibodies (SSA/SSB), rheumatoid factor (RF), anticardiolipin antibodies (ACA), and anti-double-stranded DNA antibody (A-ds DNA), anticardiolipin antibody (ACLs), anti-β2-glycoprotein I (β2-GPI) and Aquaporin-4 antibodies (AQP4-Ab). Spectral-domain optical coherence tomography (SD-OCT) was used to evaluate the atrophy of the optic nerve.Results68 patients (35.79%) had abnormal autoantibodies, 26(13.68%) patients met diagnostic criteria for CTDs, including 15(7.89%) patients meeting the criteria for SS. Antibodies including SSA/SSB 23 (30.26%) (p1 and p 2<0.001) and AQP4–Ab10 (13.16%) (p1 = 0.044, p2 = 0.01) were significantly different in patients in the RON group when compared with those in the BON (P1 = RON VS ION) and ION (p2 = RON VS ION) groups. SS was more common in RON patients (p1 = 0.04, p2 = 0.028). There was no significant difference between SSA/SSB positive and negative patients in disease characteristics or severity. Similar results were obtained when SS was diagnosed in SSA/SSB positive patients.ConclusionRON and BON were more likely associated with abnormal autoantibodies; furthermore, AQP4 antibody, SSA/SSB and SS were more common in the RON patients. AQP4 antibodydetermination is crucial in RON patients who will develop NMO. However, when compared with other autoantibodies, SSA/SSB detected in patients was not significantly associated with disease characteristics or severity.

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“…The review of the literature revealed that optic neuritis represents the 46.4% (124/267) of cranial neuritis in SS patients [7, 18, 19, 24, 34, 36, 43–45, 49, 54–56, 59, 63, 65–68, 70, 72–75, 77–81, 83, 85–93, 95–97, 100, 104]; it is often bilateral with contemporary [65, 67, 68, 70, 85, 89, 95, 97] or sequential [36, 63] occurrence. In a few cases, neuritis was associated with CNS involvement, such as brain vasculitis [34, 77], acute transverse myelopathy [43, 67], myelitis [77, 80, 83, 90], aseptic meningitis [70], or multiple sclerosis-like features [80, 91].…”

Section: Review Of the Literaturementioning

confidence: 99%

“…In a few cases, neuritis was associated with CNS involvement, such as brain vasculitis [34, 77], acute transverse myelopathy [43, 67], myelitis [77, 80, 83, 90], aseptic meningitis [70], or multiple sclerosis-like features [80, 91]. Response to treatment was frequently effective, especially with the use of immunosuppressors; however, an irreversible visual impairment was occasionally reported [45, 63, 79, 95].…”

Section: Review Of the Literaturementioning

confidence: 99%

“…Response to treatment was frequently effective, especially with the use of immunosuppressors; however, an irreversible visual impairment was occasionally reported [45, 63, 79, 95]. From a pathophysiological point of view, optic neuropathy may be related to immune-mediated small vessel vasculitis [70]; otherwise, it may be due to demyelinating disease being included or not in the neuromyelitis optica spectrum disorder [91]. …”

Section: Review Of the Literaturementioning

confidence: 99%

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Neurologic Complications Associated with Sjögren’s Disease: Case Reports and Modern Pathogenic Dilemma

Colaci

Cassone

Manfredi

et al. 2014

Case Reports in Neurological Medicine

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Objectives. Sjögren's syndrome (SS) may be complicated by some neurological manifestations, generally sensory polyneuropathy. Furthermore, involvement of cranial nerves was described as rare complications of SS. Methods. We reported 2 cases: the first one was a 40-year-old woman who developed neuritis of the left optic nerve as presenting symptom few years before the diagnosis of SS; the second was a 54-year-old woman who presented a paralysis of the right phrenic nerve 7 years after the SS onset. An exhaustive review of the literature on patients with cranial or phrenic nerve involvements was also carried out. Results. To the best of our knowledge, our second case represents the first observation of SS-associated phrenic nerve mononeuritis, while optic neuritis represents the most frequent cranial nerve involvement detectable in this connective tissue disease. Trigeminal neuropathy is also frequently reported, whereas neuritis involving the other cranial nerves is quite rare. Conclusions. Cranial nerve injury is a harmful complication of SS, even if less commonly recorded compared to peripheral neuropathy. Neurological manifestations may precede the clinical onset of SS; therefore, in patients with apparently isolated cranial nerve involvement, a correct diagnosis of the underlying SS is often delayed or overlooked entirely; in these instances, standard clinicoserological assessment is recommendable.

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Bilateral optic neuropathy revealing Sjögren's syndrome

Cited by 16 publications

References 13 publications

Systemic Lupus Erythematosus (SLE) Complicated by Neuromyelitis Optica (NMO – Devic's Disease): Clinic-Pathological Report and Review of the Literature

Systemic Lupus Erythematosus (SLE) Complicated by Neuromyelitis Optica (NMO – Devic's Disease): Clinic-Pathological Report and Review of the Literature

Frequency of Autoantibodies and Connective Tissue Diseases in Chinese Patients with Optic Neuritis

Neurologic Complications Associated with Sjögren’s Disease: Case Reports and Modern Pathogenic Dilemma

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