Efficacy of tacrolimus in Sjögren’s syndrome-associated CNS disease with aquaporin-4 autoantibodies

Fukuda, Toyoki; Shiraishi, Hiroaki; Nakamura, Tatsufumi; Tanaka, Keiko; Nakamura, Hideki; Tsujino, Akira; Nishiura, Yoshihiro; Yoshimura, Tsuyoshi; Motomura, Masakatsu; Eguchi, Katsumi

doi:10.1007/s00415-009-5175-6

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…Intravenous administration of immunoglobulins (IVIGs) in the induction or adjunctive treatment of peripheral neuropathy gives favorable results (Kizawa et al., 2006; Wakasugi et al., 2009). In the literature, there are also descriptions of effective treatment with infliximab (Mavragani & Moutsopoulos, 2007), rituximab (Gorson, Natarajan, Ropper, & Weinstein, 2007; Sève et al., 2007), and tacrolimus (Fukuda et al., 2009). In some patients, very good results can be obtained after plasmapheresis with simultaneous immunosuppressive treatment (Soliotis et al., 2004).…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, there are also descriptions of effective treatment with infliximab (Mavragani & Moutsopoulos, 2007), rituximab (Gorson, Natarajan, Ropper, & Weinstein, 2007;Sève et al, 2007), and tacrolimus (Fukuda et al, 2009). In some patients, very good results can be obtained after plasmapheresis with simultaneous immunosuppressive treatment (Soliotis et al, 2004).…”

Section: Treatmentmentioning

confidence: 99%

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Neuro‐Sjögren: Uncommon or underestimated problem?

et al. 2020

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Objectives Sjögren's syndrome (SS) is a chronic inflammatory disease with an autoimmune background with possible complications from peripheral (PNS) and central nervous system (CNS). The aim of this study was to assess the prevalence and to describe the phenotype of peripheral neuropathies in patients with SS. Materials & Methods We studied fifty patients with primary Sjögren's syndrome for peripheral nervous system involvement. All patients underwent neurological and rheumatological examination followed by nerve conduction studies (NCS) of nine peripheral nerves. Results Thirty‐six patients (72%) fulfilled the criteria for the diagnosis of neuropathy. Carpal tunnel syndrome (54%) and axonal sensorimotor neuropathy (22%) were the most common. Neurological symptoms preceded the diagnosis of SS in eight patients. Conclusions Peripheral neuropathies are frequent in SS patients. Neurologists should be aware of possible autoimmune causes of neuropathies because clinical manifestations of neuropathy may precede the development of other symptoms of the autoimmune disease.

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Section: Discussionmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Neuro‐Sjögren: Uncommon or underestimated problem?

et al. 2020

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“…Autoantibodies to aquaporin-4 (AQP-4) have been identified in association with a severe variant of multiple sclerosis [48] and there is a subset of patients with this condition, who express these autoantibodies and who also have Sjögren's syndrome [49,50]. Unfortunately, it is unlikely that these autoantibodies have a pathological role in fluid secretion in Sjögren's syndrome because AQP-4 is not found on salivary gland acinar cells.…”

Section: Anti-aquaporin Autoantibodiesmentioning

confidence: 98%

Autoantibodies and Sjogren’s Syndrome: A Physiologist’s Perspective

Smith

Dawson²

2012

CPB

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Sjögren's syndrome is a systemic autoimmune condition centred around salivary gland dysfunction and atrophy. There are a plethora of antibodies that mark the decline of the salivary glands, most of which relate to apoptopic mediated destruction of acinar cells. The best known of these autoantibodies, anti-Ro and anti-La form part of the diagnostic criteria for the condition. An emerging viewpoint in recent years is that glandular dysfunction precedes rather than follows glandular atrophy and attention has shifted to the interface between the immune system and the secretory process. An autoantibody against the muscarinic type 3 acetylcholine receptor occupies precisely this position because it inhibits the acetylcholine receptor which controls salivary and lacrimal fluid secretion. The consequence of identifying an autoantibody that can cause rather than simply reflect the disease process are manifold and could have a huge impact on development of therapeutic treatments. Furthermore, a "functional" autoantibody directed against an important component of the autonomic nervous system could also account for some of the extraglandular features of Sjögren's syndrome.

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“…Pediatric and adult case reports and retrospective studies have reported efficacy with corticosteroids, cyclophosphamide, tacrolimus, and IVIG. 57,[61][62][63] One small controlled clinical trial in adult patients demonstrated clinical improvement with IVIG therapy. 64 For movement disorders, corticosteroids or levodopa (L-dopa) (if parkinsonism present) can be trialed.…”

Section: Treatment and Prognosismentioning

confidence: 99%

Central Nervous System Involvement in Pediatric Systemic Autoimmune Diseases

Stanton

Knight

2017

J Pediatr Neurol

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Central nervous system (CNS) involvement occurs in many pediatric systemic autoimmune diseases. These manifestations are often associated with increased morbidity and mortality and can have adverse long-term effects on neurodevelopmental, health-related, and quality-of-life outcomes. In this review, we summarize the existing literature on CNS involvement in pediatric systemic autoimmune diseases, compare diagnostic findings, and describe current treatments. CNS manifestations of pediatric systemic autoimmune disease present diagnostic and management challenges due to their relatively rare occurrence in children, the difficulty in confirming direct CNS involvement as opposed to secondary symptoms occurring as a consequence of systemic inflammation, and the need to define treatment strategies effective for CNS involvement.

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Efficacy of tacrolimus in Sjögren’s syndrome-associated CNS disease with aquaporin-4 autoantibodies

Cited by 4 publications

References 11 publications

Neuro‐Sjögren: Uncommon or underestimated problem?

Neuro‐Sjögren: Uncommon or underestimated problem?

Autoantibodies and Sjogren’s Syndrome: A Physiologist’s Perspective

Central Nervous System Involvement in Pediatric Systemic Autoimmune Diseases

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