Sjogren's syndrome

[mabel]

Can Sjogren's Syndrome cause sensory or peripheral neuropathy?  If so, would negative antibody tests rule out the disorder?  If you don't want to do a lip biopsy because of after effect numbness, would a previous biopsy of the glands and tissue from the sinuses (dry also) showing lymphocytic and plasmalymphocytic infiltration suffice? I have no tear film (has been unexplained to this day), unexplained sensory neuropathy, recent case of sialadenitis, rashes, low grade fever, and dry skin.  I am a 37 year old female.

Any information you have to offer would be most helpful.

[Reenie]

Anna, forgot to say if for any reason you DO get the lip biopsy have it done by an Oral Pathologist.  This is very important!  They are the only ones who truly know what they are doing. My guy even looked at the slides himself.  He was GREAT.

[mabel]

Thank you for your comments Maureen and Judy and your answer Dr.  I don't have rheumatoid arthritis and I was trying to avoid the lip biopsy if I could.  I just didn't know if they would accept the information from the biopsy taken from my sinuses instead.

Thanks again.

[Maureen]

Hi Anna.  From the research I did on Sjogren's I found out you need two out of three positive results to be definitively diagnosed with Sjogren's.  That is:  1)  Sjogren's antibodies, 2)  Positive Schirmer's (eye moisture test), or 3)  Positive lip biopsy.  

I did get the lip biopsy.  Mine was negative.  It was  a little numb but it is normal now.  I just have a slight scar there.  The only positive thing I have is the Schirmer's.  You can have Dry Eye Syndrome without having Sjogren's.  I also have some sort of neuromuscular pattern - twitching, parasthesias, and pain (which has resolved over the years....).  I have read there are lots of women with Sjogren's who do not test postive for the antibodies but do have positive results in the other two criteria.  Hope this helps.

[Judy - Follow-up question]

Hi Anna,

I have RA and am searching for the cause of neurological symptoms of numbness, tingling and minor pain. Most dominant for me over the last year has been facial numbness. I have done numberous searches on that and located places that say that sometimes Sjogren's presents with this. Although I believe it is not very common.

If you make progress with your diagnosis, please post the results. I would be quite interested. I believe RA and sjogrens' are related.

Let us know what happens.
Best wishes.

[CCF Neuro[P] MD, RPS]

Dear Anna:

Sorry to hear about your Sjogren's syndrome.  Yes, one can see a peripheral neuropathy with Sjogren's.  One can also see Rheumatoid Arthritis which in turn can cause a peripheral sensory neuropathy or motor neuropathy.  I am not a rheumatologist, but as I remember, the diagnosis of Sjogern's is a clinical diagnosis and it would seem to me that a positive biopsy would be diagnostic.

Sincerely,

CCF Neruo MD