Peripheral neuropathy and health-related quality of life in patients with primary Sjögren’s syndrome: a preliminary report

Abstract

Sjögren's syndrome (SS) is a chronic autoimmune disease with a wide spectrum of possible organ involvement. Peripheral (PNS) and central nervous system (CNS)-related symptoms may occur in the course of the disease. The aim of this study was to compare the health-related quality of life (HR-QOL) in SS patients with and without peripheral neuropathy. The study involved 50 patients with primary Sjögren's syndrome (pSS). All patients underwent neurological clinical examination followed by nerve conduction studies (NCS) and rheumatological examination. Thirty-six-item Short Form Health Survey (SF-36) was used for evaluating HR-QOL. To assess pSS activity, the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) and EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) were used. For the assessment of clinical disability due to peripheral neuropathy, the Overall Disability Sum Score scale (ODSS) was used. Additional evaluation of pain was performed with the use of the Visual Analogue Scale (VAS) and a semistructured interview. Twenty-three (46%) patients were diagnosed with peripheral neuropathy. The most common PNS manifestation was sensorimotor neuropathy (47%). Neurological symptoms preceded the diagnosis of pSS in eight patients. The following domains of the SF-36 form were significantly lower scored by patients with peripheral nervous system involvement: role-physical [0 (0-100) vs. 75 (0-100)], role-emotional [67 (0-100) vs. 100 (0-100)], vitality [40 (10-70) vs. 50 (20-75)], bodily pain [45 (10-75) vs. 55 (0-100)], and general health [20 (5-50) vs. 30 (0-50)] (p ≤ 0.05). Our study showed that peripheral neuropathy was a common organ-specific complication in SS patients. In pSS patients, coexisting neurological involvement with symptoms such as pain and physical disability may be responsible for diminished HR-QOL.

Interferon alpha serum level association with low vitamin D levels in Chinese patients with primary Sjögren’s syndrome

“…24 Among the extraglandular manifestations of pSS, the occurrence of PNS involvement is reported with the frequency of 10%-46%. 25,26 According to our results, vitamin D levels of patients with pSS are inverse correlated with PNS domain. This finding is supported by one previous study, suggesting decreasing vitamin D levels maybe associated with neuropathy among pSS patients.…”

Peripheral Nervous System Involvement in Sjögren’s Syndrome: Analysis of a Cohort From the Italian Research Group on Sjögren’s Syndrome

“…We confirmed a relatively high prevalence of pure sensory neuropathy ( 14 – 16 , 21 , 24 – 36 ). This manifestation may have a negative impact on disease outcome and patient quality of life due to disabling symptoms, often requiring immunosuppressive therapies ( 37 – 39 ). pSS subjects with evidence of pure sensory neuropathies, including SFN and DRG, are usually characterized by a low prevalence of serological markers of chronic B-cell activation, including ANA, anti-Ro/SSA, anti-La/SSB and rheumatoid factor ( 14 – 16 , 21 , 24 – 36 ).…”

Is fibromyalgia accompanying Behçet's disease more severe than primary fibromyalgia?

“…Central nervous system involvement can be seen in both BD and Sjögren's syndrome [34,35]. We do not know whether there is peripheral nerve involvement in BD with the literature information so far; however, in Sjögren's syndrome, peripheral nerves are frequently affected [36]. In the study of Ostuni et al [32], higher pain thresholds in the presence of Sjögren's syndrome in FM patients may be related to the effect of Sjogren's syndrome on the peripheral nerves.…”