vitamin-b-12 and Sjogren-s-Syndrome

Sjogren's syndrome, involving sicca symptoms with xerostomia, stomatitis, and considerable pain is a difficult-to-treat autoimmune disease where the treatment options are limited and, as in the case of methotrexate, have a low therapeutic index.. This case report concerns a male patient, aged 75 years and vegetarian, with Sjogren's syndrome subsequently confirmed by salivary gland biopsy. Serum antinuclear antibodies (ANA) were elevated (1 : 320). Low serum vitamin B12 and iron levels could be improved after 20 days using vitamin B12 and iron oral supplements. Despite symptomatic treatment, xerostomia, glossitis, and glossodynia were still present, at times marked, after 12 months when the ANA titer was unchanged. Following treatment with an anti-inflammatory polyvalent immunoglobulin formulation (Lactobin. This case report demonstrates the satisfactory control of Sjogren's syndrome using oral polyvalent immunoglobulins with vitamin D3. In contrast to treatment options involving antimalarial drugs and methotrexate, there are no safety issues in patients tolerant to milk products.
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Topics: Aged; Antibodies, Antinuclear; Cholecalciferol; Humans; Immunoglobulins; Male; Sjogren's Syndrome; Stomatitis; Vegetarians; Vitamin B 12

Sjögren syndrome is a common, chronic autoimmune disease that typically produces inflammation and poor function of the salivary and lacrimal glands. Other organs can be affected, including the nervous system. Sensory peripheral neuropathy is a common manifestation of the disease.. Eight-eight patients attending a dry eyes-dry mouth clinic were diagnosed to have primary Sjögren syndrome and underwent a neurological examination. Anti-Ro (or SSA) and anti-La (or SSB) were determined using immunodiffusion as well as Inno-Lia and BioPlex ANA screen. Serum vitamin B(12) levels were determined using an enzyme-linked microtiter plate assay.. Twenty-seven (31%) of the 88 patients had peripheral neuropathy as defined by loss of light touch, proprioception, or vibratory sensation. Anti-Ro and anti-La were found by immunodiffusion in 12 patients, and 8 of these 12 had neuropathy (χ(2) = 8.46, P = 0.0036, odds ratio = 6.0 compared to those without precipitating anti-Ro and anti-La). Of the 27 patients with only anti-Ro by immunodiffusion, 13 (48.1%) had neuropathy (χ(2) = 5.587, P = 0.018, compared to those without anti-Ro). There was no relationship of the other, more sensitive measures of anti-Ro and anti-La to neuropathy. In addition, we found no association of serum vitamin B(12) levels to neuropathy among these patients with Sjögren syndrome.. Sensory peripheral neuropathy is common among patients with Sjögren syndrome and is associated with the presence of anti-Ro and anti-La when determined by immunodiffusion.

Topics: Adult; Aged; Antibodies, Antinuclear; Autoantigens; Cohort Studies; Female; Humans; Immunodiffusion; Male; Middle Aged; Peripheral Nervous System Diseases; Ribonucleoproteins; Sjogren's Syndrome; SS-B Antigen; Vitamin B 12

Topics: Diagnosis, Differential; Female; Humans; Male; Middle Aged; Sjogren's Syndrome; Spinal Cord Diseases; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Antibodies, Antinuclear; Arthralgia; Arthritis; Autoantigens; Female; France; Humans; Male; Mental Disorders; Middle Aged; Nervous System Diseases; Prevalence; Raynaud Disease; Sjogren's Syndrome; Vitamin B 12; Vitamin B 12 Deficiency

Differing cranial nerve involvement has been reported in the context of Gougerot-Sjögren's syndrome. Involvement of the V, III and VII nerves has been reported, the most characteristic being nerve V, notably its lower branch. Rare, well documented, cases of facial palsy have also been described.. Recurrent facial palsy in a 40 year-old woman revealed a primary Sjögren's syndrome and vitamin B12 deficiency.. The onset of facial palsy has been linked with Gougerot-Sjögren's syndrome. The contribution of vitamin B12 deficiency is discussed.

Topics: Adult; Anti-Inflammatory Agents; Antirheumatic Agents; Electromyography; Facial Paralysis; Female; Humans; Hydroxychloroquine; Immunosuppressive Agents; Magnetic Resonance Imaging; Physical Therapy Modalities; Recurrence; Sjogren's Syndrome; Thyroiditis, Autoimmune; Treatment Outcome; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Aged; Anemia, Macrocytic; Arthritis, Rheumatoid; Female; Gastric Juice; Humans; Middle Aged; Sjogren's Syndrome; Vitamin B 12; Vitamin B 12 Deficiency