A Case of Primary Sjogren's Syndrome Presenting as Adie's Syndrome / 대한류마티스학회지

ABSTRACT

Sjogren's syndrome is a hererogenous autoimmune disease characterized by progressive destruction of the exocrine glands and accompanied by a variety of autoimmune phenomena. Sjogren's syndrome patients can develop symptoms of ocular and oral dryness as well as extraglandular complications including central and peripheral nervous system disease. Sometimes neuropathy precedes the diagnosis of Sjogren's syndrome. Adiets syndrome is characterized by tonic pupil and the absence of tendon reflex. Sweating abnormality and chronic peripheral polyneuropathy can also be present. We report a case of primary Sjogren's syndrome preceded by Adie's syndrome with peripheral neuropathy. A 26-year-old woman was admitted for photophobia and paresthesia. On examination, her pupils were anisocoric and did not react to light but constricted promptly to pilocarpin. Sensation decreased on her left side of body and deep' tendon reflexes were absent. Biopsy of minor salivary gland demonstrated infiltration by lymphocyte consistent with Sjogren's syndrome, but Schirmer test was negative. So she was diagnosed as Adie's syndrome with peripheral neuropathy. Five month later she complained of dry eye and dizziness. Rose bengal staining was positive. Sjogren's syndrome was diagnosed and she was discharged with local therapy for the sicca symptoms.