Patterns of peripheral neuropathy in Sjogren's syndrome in a tertiary care hospital from South India

Yareeda, Sireesha; Kanikannan, Meena A; Pyal, Anjan; Sandeep, G; Uppin, Megha S; Kandadai, Rukmini Mridula; Jabeen, Shaik Afshan; Varaprasad, Rajendra; Rajasekhar, Liza; Neeharika, Mathukumalli L; Borgohain, Rupam

doi:10.4103/0028-3886.250714

Cited by 5 publications

(7 citation statements)

References 2 publications

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“…The study selection process is illustrated in the PRISMA chart (Figure 1 ). All of the 49 studies that met our inclusion criteria [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 ] were of an observational nature. The majority of the papers were published by research teams that included both rheumatologists/internists and neurologists ( n = 31) followed by research teams that included either only rheumatologists/internists ( n = 12) or only neurologists ( n = 6).…”

Section: Resultsmentioning

confidence: 99%

Primary Sjögren syndrome‐related peripheral neuropathy: A systematic review and meta‐analysis

Liampas

Parperis

Erotocritou

et al. 2022

Euro J of Neurology

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Section: Resultsmentioning

confidence: 99%

Primary Sjögren syndrome‐related peripheral neuropathy: A systematic review and meta‐analysis

Liampas

Parperis

Erotocritou

et al. 2022

Euro J of Neurology

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“…Only one crosssectional study from China in 2018 compared pSS with sSS and reported that sSS patients had a higher prevalence of PN events than pSS patients (31.1% vs. 19%) [17]. Several previous studies found a higher frequency of symmetric sensorimotor polyneuropathy and symmetric sensory polyneuropathy [24,25], but mononeuropathy or mononeuritis multiplex was the most common pattern in these studies [21][22][23]. It is difficult to estimate the precise determination of the prevalence of these manifestations, partly due to the criteria-related variations for inclusion of patients and those related to the recruitment of patients studied, and the manifestations considered.…”

Section: Sjögren's Syndrome (Ss)mentioning

confidence: 92%

“…SS is the second most common chronic autoimmune rheumatic disease, including primary Sjögren's syndrome (pSS) and secondary Sjögren's syndrome (sSS). We found six valid cross-sectional studies and one cohort study that discussed the prevalence and clinical features of PN in SS [17][18][19][20][21][22][23]. In the studies on pSS, the reported prevalence of PN events ranged from 19% to 72% and could be the initial manifestation [17][18][19][20][21][22][23].…”

Section: Sjögren's Syndrome (Ss)mentioning

confidence: 99%

“…We found six valid cross-sectional studies and one cohort study that discussed the prevalence and clinical features of PN in SS [17][18][19][20][21][22][23]. In the studies on pSS, the reported prevalence of PN events ranged from 19% to 72% and could be the initial manifestation [17][18][19][20][21][22][23]. Only one crosssectional study from China in 2018 compared pSS with sSS and reported that sSS patients had a higher prevalence of PN events than pSS patients (31.1% vs. 19%) [17].…”

Section: Sjögren's Syndrome (Ss)mentioning

confidence: 99%

“…An acute or a subacute onset was observed more frequently for multiple cranial neuropathies. Atypical presentations included pure motor neuropathies [18], hypertrophic neuropathy [26] and ganglionopathy [21].…”

Section: Sjögren's Syndrome (Ss)mentioning

confidence: 99%

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Clinical Manifestations, Pathogenesis, Diagnosis and Treatment of Peripheral Neuropathies in Connective Tissue Diseases: More Diverse and Frequent in Different Subtypes than Expected

Jin

Liu

2021

Diagnostics

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Purpose of review: To discuss and summarize recent findings in peripheral neuropathy (PN) related to connective tissue diseases (CTD) including its prevalence, clinical manifestations, pathogenesis, diagnosis and treatment. Recent findings: Although PN is a common complication in CTD and has been well studied, recent research has shown that PN is more diverse and frequent in different subtypes of CTD than was expected. The incidence of PN in Sjögren’s syndrome and rheumatoid arthritis (RA) varies according to different disease subtypes, and the pathogenesis of neuropathic pain in different subtypes of eosinophilic granulomatosis with polyangiitis (EGPA) may also differ. Neurogenic inflammation, autoantibody-mediated changes, ischemia of the vascular wall and metabolic mechanisms have been shown to contribute to the pathogenesis of PN in CTD. Moreover, allergic inflammation has been recently identified as a possible new mechanism producing peripheral neuropathic pain associated with MPO-ANCA negative EGPA patients. Glucocorticoids are routinely used to relieve pain caused by PN. However, these steroids may cause hyperalgesia, exacerbate neuropathic pain, and activate the early phase of pain induction and produce hyperalgesia. Recently, neuroactive steroids, such as progesterone, tetrahydroprogesterone and testosterone, have been shown to exert protective effects for several PN symptoms, and in particular neuropathic pain. Neuroactive steroids will be an interesting topic for future research into PN in CTD. Summary: It is essential for the diagnosis and treatment of PN in CTD to be updated. Timely diagnosis, appropriate treatments, and multidisciplinary care are essential to minimize morbidity and decrease the risk of permanent neurologic deficits. Further studies are needed to guide diagnosis and treatment.

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Central and Peripheral Nervous System Complications of Vasculitis Syndromes from Pathology to Bedside: Part 2—Peripheral Nervous System

Mansueto

Lanza

Falleti

et al. 2023

Curr Neurol Neurosci Rep

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Purpose of Review Peripheral nervous system vasculitides (PNSV) are a heterogeneous group of disorders with a clinical subset that may differ in prognosis and therapy. We provide a comprehensive update on the clinical assessment, diagnosis, complications, treatment, and follow-up of PNSV. Recent Findings Progress in neuroimaging, molecular testing, and peripheral nerve biopsy has improved clinical assessment and decision-making of PNSV, also providing novel insights on how to prevent misdiagnosis and increase diagnostic certainty. Advances in imaging techniques, allowing to clearly display the vessel walls, have also enhanced the possibility to differentiate inflammatory from non-inflammatory vascular lesions, while recent histopathology data have identified the main morphological criteria for more accurate diagnosis and differential diagnoses. Overall, the identification of peculiar morphological findings tends to improve diagnostic accuracy by defining a clearer boundary between systemic and non-systemic neuropathies. Therefore, the definition of epineurium vessel wall damage, type of vascular lesion, characterization of lymphocyte populations, antibodies, and inflammatory factors, as well as the identification of direct nerve damage or degeneration, are the common goals for pathologists and clinicians, who will both benefit for data integration and findings translation. Nevertheless, to date, treatment is still largely empiric and, in some cases, unsatisfactory, thus often precluding precise prognostic prediction. In this context, new diagnostic techniques and multidisciplinary management will be essential in the proper diagnosis and prompt management of PNSV, as highlighted in the present review. Summary Thirty to fifty percent of all patients with vasculitis have signs of polyneuropathy. Neuropathies associated with systemic vasculitis are best managed according to the guidelines of the underlying disease because appropriate workup and initiation of treatment can reduce morbidity. Steroids, or in severe or progressive cases, cyclophosphamide pulse therapy is the standard therapy in non-systemic vasculitic neuropathies. Some patients need long-term immunosuppression. The use of novel technologies for high-throughput genotyping will permit to determine the genetic influence of related phenotypes in patients with PNSV. Supplementary Information The online version contains supplementary material available at 10.1007/s11910-023-01249-3.

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Patterns of peripheral neuropathy in Sjogren's syndrome in a tertiary care hospital from South India

Cited by 5 publications

References 2 publications

Primary Sjögren syndrome‐related peripheral neuropathy: A systematic review and meta‐analysis

Primary Sjögren syndrome‐related peripheral neuropathy: A systematic review and meta‐analysis

Clinical Manifestations, Pathogenesis, Diagnosis and Treatment of Peripheral Neuropathies in Connective Tissue Diseases: More Diverse and Frequent in Different Subtypes than Expected

Central and Peripheral Nervous System Complications of Vasculitis Syndromes from Pathology to Bedside: Part 2—Peripheral Nervous System

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