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Relation of Sensory Peripheral Neuropathy in Sjögren Syndrome to Anti-Ro/SSA

Scofield, Amanda Kyle*; Radfar, Lida DDS; Ice, John A. MD*; Vista, Evan MD; Anaya, Juan-Manuel MD; Houston, Glen DDS; Lewis, David DDS; Stone, Donald U. MD¶#; Chodosh, James MD††; Hefner, Kimberly MD*; Lessard, Christopher J. PhD*; Moser, Kathy L. PhD*‡; Scofield, Robert Hal MD*†**

JCR: Journal of Clinical Rheumatology: September 2012 - Volume 18 - Issue 6 - p 290–293
doi: 10.1097/RHU.0b013e3182675e4f
Original Articles

Background Sjögren syndrome is a common, chronic autoimmune disease that typically produces inflammation and poor function of the salivary and lacrimal glands. Other organs can be affected, including the nervous system. Sensory peripheral neuropathy is a common manifestation of the disease.

Methods Eight-eight patients attending a dry eyes–dry mouth clinic were diagnosed to have primary Sjögren syndrome and underwent a neurological examination. Anti-Ro (or SSA) and anti-La (or SSB) were determined using immunodiffusion as well as Inno-Lia and BioPlex ANA screen. Serum vitamin B12 levels were determined using an enzyme-linked microtiter plate assay.

Results Twenty-seven (31%) of the 88 patients had peripheral neuropathy as defined by loss of light touch, proprioception, or vibratory sensation. Anti-Ro and anti-La were found by immunodiffusion in 12 patients, and 8 of these 12 had neuropathy (χ2 = 8.46, P = 0.0036, odds ratio = 6.0 compared to those without precipitating anti-Ro and anti-La). Of the 27 patients with only anti-Ro by immunodiffusion, 13 (48.1%) had neuropathy (χ2 = 5.587, P = 0.018, compared to those without anti-Ro). There was no relationship of the other, more sensitive measures of anti-Ro and anti-La to neuropathy. In addition, we found no association of serum vitamin B12 levels to neuropathy among these patients with Sjögren syndrome.

Conclusions Sensory peripheral neuropathy is common among patients with Sjögren syndrome and is associated with the presence of anti-Ro and anti-La when determined by immunodiffusion.

From the *Arthritis & Clinical Immunology Program, Oklahoma Medical Research Foundation; †Department of Medicine, ‡Pathology, and ∥Ophthalmology, University of Oklahoma Health Sciences Center; ¶College ofDentistry, University of Oklahoma Health Sciences Center; the #DeanMcGee Eye Institute; and the **Department of Veterans Affairs Medical Center, Oklahoma City, OK; ††Massachusetts Eye & Ear Infirmary andHarvard Medical School, Boston, MA; ‡‡Center for Autoimmune Diseases Research, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Columbia.

This work was supported in part by a Center of Research Translation award from the National Institute of Arthritis, Musculoskeletal, and Skin Diseases. D.U.S. and J.C. were supported by a Research to Prevent Blindness grant to the OUHSC Department of Ophthalmology and the Dean McGee Eye Institute.

The authors declare no conflict of interest.

Correspondence: Robert Hal Scofield, MD, 825 NE 13th St, MS24, Oklahoma City, OK 73104. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.