Acute meningoencephalomyelitis in an exacerbation of primary Sjögren's syndrome
Abstract
A middle-aged woman with long-standing primary Sjögren's syndrome presented with a 2 month history of persistent headaches that acutely worsened over 5 days, accompanied by new-onset gait instability, bulbar symptoms, renal impairment and a recurrent cutaneous flare in sun-exposed areas. Neurological examination revealed bradyphrenia, flaccid dysarthria, an absent gag reflex, generalised hyperreflexia and axial ataxia. Neuroimaging demonstrated diffuse brainstem and subcortical hyperintensities, pachymeningeal enhancement, arterial calibre changes and a diffusion-restricted lesion. Cerebrospinal fluid analysis revealed mild protein elevation without pleocytosis and negative results on infectious and autoimmune panels. After excluding alternative aetiologies, central nervous system involvement secondary to Sjögren's syndrome was suspected. A 3-days intravenous methylprednisolone bolus was administered, followed by an initial cycle of cyclophosphamide. Neurological improvement was achieved in 10 days. Complete clinical and imaging resolution was observed in 1 month, with stable outcomes at 1 year follow-up. This case emphasises the importance of early recognition of severe Sjögren's manifestations.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Calcium Ions in the Physiology and Pathology of the Central Nervous System
- AI-powered in silico twins: redefining precision medicine through simulation, personalization, and predictive healthcare
- In silico functional, structural and pathogenicity analysis of missense single nucleotide polymorphisms in human MCM6 gene
- In Silico drug repurposing pipeline using deep learning and structure based approaches in epilepsy
- Targeting serotonin receptors with phytochemicals – an in-silico study
- In silico exploration of anti-prostate cancer compounds from differential expressed genes
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.