Primary Sjögren's Syndrome Presenting with Rapidly Progressive Dementia: A Case Report.

Sjögren’s syndrome autoimmune diseases of the nervous system case report creutzfeldt jakob disease dementia electroencephalography source imaging neurocognitive disorders

Journal

Current Alzheimer research
ISSN: 1875-5828
Titre abrégé: Curr Alzheimer Res
Pays: United Arab Emirates
ID NLM: 101208441

Informations de publication

Date de publication:
2022
Historique:
received: 27 02 2022
revised: 06 04 2022
accepted: 26 04 2022
pubmed: 29 6 2022
medline: 27 10 2022
entrez: 28 6 2022
Statut: ppublish

Résumé

Rapidly progressive dementias (RPDs) are dementias that progress subacutely over a time period of weeks to months. Primary Sjögren's syndrome (pSS) is an autoimmune disease that can affect any organ system and may present with a wide range of clinical features that may mimic a plethora of medical conditions and, in rare cases, may manifest as RPD. We describe a unique case of pSS, in which rapidly progressive dementia (RPD) was the first disease manifestation, and the patient's radiological and electroencephalogram findings were compatible with Creutzfeldt- Jakob disease (CJD). Here, we report a 58-year-old woman who presented with cognitive impairment rapidly deteriorating over the last 6 months prior to admission. Brain MRI and EEG were indicative of CJD. However, CSF 14-3-3 and tau/phospho tau ratio were within normal limits and therefore alternative diagnoses were considered. Blood tests were significant for positive antinuclear antibodies, anti-ENA, and anti-SSA and a lip biopsy was consistent with pSS. The patient was started on intravenous steroids followed by oral prednisone taper, which prevented further deterioration. This rare case expands the spectrum of neurological manifestations in pSS and highlights the importance of considering pSS in the differential diagnosis of RPDs in order to avoid misdiagnosis and provide appropriate treatment in a timely fashion.

Sections du résumé

BACKGROUND
Rapidly progressive dementias (RPDs) are dementias that progress subacutely over a time period of weeks to months. Primary Sjögren's syndrome (pSS) is an autoimmune disease that can affect any organ system and may present with a wide range of clinical features that may mimic a plethora of medical conditions and, in rare cases, may manifest as RPD. We describe a unique case of pSS, in which rapidly progressive dementia (RPD) was the first disease manifestation, and the patient's radiological and electroencephalogram findings were compatible with Creutzfeldt- Jakob disease (CJD).
CASE PRESENTATION
Here, we report a 58-year-old woman who presented with cognitive impairment rapidly deteriorating over the last 6 months prior to admission. Brain MRI and EEG were indicative of CJD. However, CSF 14-3-3 and tau/phospho tau ratio were within normal limits and therefore alternative diagnoses were considered. Blood tests were significant for positive antinuclear antibodies, anti-ENA, and anti-SSA and a lip biopsy was consistent with pSS. The patient was started on intravenous steroids followed by oral prednisone taper, which prevented further deterioration.
CONCLUSION
This rare case expands the spectrum of neurological manifestations in pSS and highlights the importance of considering pSS in the differential diagnosis of RPDs in order to avoid misdiagnosis and provide appropriate treatment in a timely fashion.

Identifiants

pubmed: 35761497
pii: CAR-EPUB-124792
doi: 10.2174/1567205019666220627094707
doi:

Substances chimiques

Prednisone VB0R961HZT
Antibodies, Antinuclear 0

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

479-484

Informations de copyright

Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.

Auteurs

Konstantinos Notas (K)

Laboratory of Clinical Neurophysiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Stilponos Kyriakidi 1, 54636, Thessaloniki, Greece.

Vasileios Papaliagkas (V)

Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, Thessaloniki, Greece.

Martha Spilioti (M)

1st Department of Neurology, Aristotle University of Thessaloniki, AHEPA University Hospital, Stilponos Kyriakidi 1, 54636, Thessaloniki, Greece.

Ioannis Papagiannis (I)

1st Department of Neurology, Aristotle University of Thessaloniki, AHEPA University Hospital, Stilponos Kyriakidi 1, 54636, Thessaloniki, Greece.

Petros Nemtsas (P)

Laboratory of Clinical Neurophysiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Stilponos Kyriakidi 1, 54636, Thessaloniki, Greece.

Athanasios Poulopoulos (A)

Department of Oral Medicine and Maxillofacial Pathology, Dental School of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Konstantinos Kouskouras (K)

Department of Radiology, Aristotle University of Thessaloniki, AHEPA University General Hospital, Thessaloniki, Greece.

Ioannis Diakogiannis (I)

1st Department of Psychiatry, Aristotle University of Thessaloniki, General Hospital "Papageorgiou", Thessaloniki, Greece.

Vasilios K Kimiskidis (VK)

1st Department of Neurology, Aristotle University of Thessaloniki, AHEPA University Hospital, Stilponos Kyriakidi 1, 54636, Thessaloniki, Greece.

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Classifications MeSH