Nöropsikiyatri Arşivi; 2014;51(2):148-156
Nörologlar Nasıl Primer Sjögren Sendromu Tanısı Koyar?
S Karaca, EDE Bozkırlı, BK Göksel, M Tan, AE Yücel
Başkent University, Adana
Introduction: Neurological involvements were shown in 20% of patients with Primary
Sjogren’s Syndrome (pSS). Neurological symptoms may be the first signs of pSS in 57%
of the cases. In addition, early diagnosis and treatment of neurological disorders may
save or improve the quality of life of these cases. There have been reports about the
neurologic manifestations of pSS but little is known about the details of neurologically
presented cases.
Method:
In this study, we described 11 pSS patients who presented with neurological
manifestations.
Results:
Central nervous system (CNS) involvement was recorded in 7 (63.7%) and
peripheric nervous system (PNS) involvement in 4 cases (36.4%).
Conclusion:
Our findings regarding the cases with neurological manifestations leading
to the diagnosis of pSS suggest that: 1) The frequency of CNS involvement was higher
than that of PNS, and the most frequent clinical pictures of CNS involvement are Multiple
Sclerosis (MS)-like illnesses and optic neuritis, 2) Guillain Barre Syndrome (GBS) was
the most frequent disease of PNS involvement; 3) Mononeuropathy multiplex (MM)
might be the first sign of pSS; 4) Neurologists should consider pSS in the differential
diagnosis of cases with MS, optic neuritis, GBS and neuropathies of unknown causes
including MM; 5) There is an urgent need of therapeutical guidelines for the cases with
neurological involvement associated with pSS
If Neurologists Establish The Diagnosis of Primary Sjogren’s Syndrome?
Giris: Primer Sjögren Sendromlu (PSS) hastalarin %20’sinde nörolojik tutulum oldugu
gösterilmistir. Olgularin %57’sinde ise ilk olarak nörolojik belirtiler ortaya çikmaktadir.
Nörologlarin bu belirtileri erkenden tespit etmesi ve PSS tedavisine baslanmasi ile
hastalarin yasami kurtarilabilmekte ve/veya yasam kalitesi arttirilabilmektedir. PSS ile
iliskili nörolojik hastaliklar oldukça iyi tanimlanmistir ancak nörolojik bulgularla prezante
olan olgularda PSS tanisi için detayli bilgi bulunmamaktadir.
Yöntem:
Bu çalismada nörolojik bulgular ile basvuran 11 hastada PSS tanimlanmistir.
Bulgular: Yedi olguda (%63,7) merkezi sinir sistemi (CNS) tutulumu belirlenirken, 4
olguda (%36,4) periferik sinir sistemi (PNS) tutulumu saptanmistir.
Sonuç: Nörolojik hastaliklari nedeniyle PSS tanisi alan bu olgularin degerlendirmesi
sonucu bulgularimiz sunlardir: 1) PSS’in ilk bulgusu olarak CNS tutulumu, PNS
tutulumundan daha sik ortaya çikmaktadir, CNS tutulumu ile giden klinik tablolardan
en sik Multiple Skleroz (MS) benzeri hastalik ve optik nevrit görülmektedir; 2) Guillain
Barre Sendromu (GBS) PNS tutulumu ile iliskili en sik gözlenen klinik tablodur; 3)
Mononöropati multipleks (MM) PSS’nin ilk isareti olabilmektedir; 4) Nörologlarin MS,
optik nevrit ve GBS yani sira MM dâhil tüm nedeni bilinmeyen nöropati olgularinin
ayirici tanisinda PSS düsünmesi gerekmektedir; 5) PSS ile iliskili nörolojik tutulumu
olan olgular için acil olarak tedavi kilavuzuna ihtiyaç bulunmaktadir