Sjogren's myelitis presenting as hemicord syndrome.


Journal

Clinical medicine (London, England)
ISSN: 1473-4893
Titre abrégé: Clin Med (Lond)
Pays: England
ID NLM: 101092853

Informations de publication

Date de publication:
07 2023
Historique:
medline: 5 10 2023
pubmed: 1 8 2023
entrez: 31 7 2023
Statut: ppublish

Résumé

We present a case where a 63-year-old right-handed man who presented with a 6-month history of progressive asymmetrical sensorimotor symptoms in lower limbs. This was associated with concomitant rash on the lower limbs, and mild sicca symptoms. MRI spine showed focal T2 hyperintensity in the left hemicord at C3-4 level. Skin biopsy of the rash revealed urticarial vasculitis, and lip biopsy revealed lymphocytic sialadenitis. Initial anti-Ro antibody was negative, but subsequent Ro52 antibody testing returned positive. There was also matched serum and cerebrospinal fluid oligoclonal bands. He was subsequently diagnosed as Sjogren's myelitis and treated with intravenous methylprednisolone, then transitioned to a steroid sparing agent. This case highlights the difficulties in reaching a rheumatological diagnosis in the early stages with typical negative antibodies, and shows a rare neurological manifestation of a systemic rheumatological condition.

Identifiants

pubmed: 37524434
pii: 23/4/423
doi: 10.7861/clinmed.2023-0158
pmc: PMC10541053
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

423-424

Informations de copyright

© Royal College of Physicians 2023. All rights reserved.

Références

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pubmed: 27110384
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pubmed: 24307005
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pubmed: 14717615
Arch Intern Med. 2004 Jun 28;164(12):1275-84
pubmed: 15226160
Ann Rheum Dis. 2015 Nov;74(11):1983-9
pubmed: 24938285
Rheum Dis Clin North Am. 2017 Nov;43(4):519-529
pubmed: 29061239
Arthritis Rheumatol. 2017 Jan;69(1):35-45
pubmed: 27785888

Auteurs

Andrew Lee (A)

Nottingham University Hospitals NHS Trust, Nottingham, UK.

Ira Pande (I)

Nottingham University Hospitals NHS Trust, Nottingham, UK.

Bruno Gran (B)

Nottingham University Hospitals NHS Trust, Nottingham, UK, and consultant neurologist, University of Nottingham School of Medicine, Nottingham, UK Bruno.Gran@nuh.nhs.uk.

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Classifications MeSH