Objective: explain the cause of parkinsonism in Sjogren’s syndrome

Background: Sjogren’s syndrome (SS) may be associated with various pathologies of the central nervous system. It is well known that Parkinson’s disease (PS) is very rare and is detected early in this abnormal pathology.

Method: Case 1: A 67-year-old patient with follow-up corticosteroid therapy since 2011 for mucocutaneous seronegative SS. She had Tremo-Akineto-Parkinson syndrome, bilateral and asymmetric, that had been exacerbated for 4 years, but responded markedly to dopa therapy. Brain MRI showed demyelinating lesions in the brain (WM) and periventricular paracortical white matter.

Case 2: 72-year-old patient diagnosed with primary SS with gait disturbance for 3 years, with bilateral and asymmetric tremor-anakinesia-tonic parkinsonism, tetrapyramidal syndrome, and pseudobulbar syndrome . MRI of the brain showed lesions in the WM and gray matter. Treatment with a combination of levodopa, corticosteroid therapy, and immunosuppressants partially improves symptoms.

Results: Our patient had PS associated with SS. This association could be explained by a common immune pathogenesis or a chance association between SS and Parkinson’s disease (PD). Recently, an Asian study showed that SS is a risk factor for PD. The absence of atypia in our patients suggests association rather than causation.

Conclusion: There may be a common immunopathogenesis between these two diseases (an inflammatory disease and a neurodegenerative disease), opening up new therapeutic prospects for PD, which has long been known as a neurodegenerative disease.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/parkinsonism-in-sjogren-disease/