Sjogren's syndrome central nervous system disease (SS-CNS) mimicking multiple sclerosis (MS)

Brain abnormalities in Sjogren syndrome with recurrent CNS manifestations: association with neuromyelitis optica

“…Neurologic involvement has been described in SS patients since 1935, and central nervous system (CNS) involvement has been variably reported in 0 -68% of the patients [1][2][3]. Although the CNS features of SS sometimes can mimic multiple sclerosis (MS), it is generally agreed that SS is an exclusion criteria for the diagnosis of MS in Asians [4][5][6]. By contrast, optic neuritis or longitudinally extensive myelitis associated with systemic autoimmune diseases can be related to neuromyelitis optica (NMO).…”

Reversible cortical lesions in primary Sjögren's syndrome presenting with meningoencephalitis as an initial manifestation

“…In SjS patients with neuropsychiatry manifestations, focal brain lesions on MRI have been reported to be located predominantly within the periventricular or subcortical white matter [7,9], except in one case in which the lesions were confined to the limbic cortex [6]. In our patient, the remarkable response of the cortical lesions involving the white matter to steroid therapy indicated inflammatory pathogenesis of the lesions.…”

Should we systematically test patients with clinically isolated syndrome for auto-antibodies?

“…As we have previously mentioned, one auto-Ab+ patient of our cohort developed SS, which has been described as a 'mimic' of MS. 34 However, it cannot be ruled out that some of these cases reported as SS mimicking MS were actually a coexistence of both diseases. CNS involvement in SS has been described as the presence of vascular or demyelinating lesions, both in brain and spinal cord, sometimes involving basal ganglia, which usually do not have the typical distribution of MS lesions, even though on occasions they can fulfil BT criteria.…”