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Ultrasonographic Evaluation of Salivary Glands for Sjogren's Syndrome: Diagnostic and Monitoring Insights
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[Membranous glomerulonephritis during primary Gougerot-Sjögren syndrome]

R Laraki1, D Chauveau, L H Noel

  • 1Cabinet de médecine interne, Casablanca, Maroc.

Presse Medicale (Paris, France : 1983)
|December 13, 2005
PubMed
Abstract

Insights

Sjögren's syndrome (SS) can cause kidney disease like membranous glomerulonephritis (MG), even without dry eyes or mouth. A combination therapy of methylprednisolone and cyclophosphamide effectively treated MG in an SS patient when steroids failed.

Area of Science:

  • Nephrology
  • Rheumatology
  • Immunology

Background:

  • Sjögren's syndrome (SS) is primarily associated with interstitial kidney disease.
  • Glomerulonephritis, specifically membranous glomerulonephritis (MG), is a less common renal manifestation of SS.

Observation:

  • A 40-year-old woman with primary SS presented with inferior vena cava and renal vein thrombosis, indicative of underlying MG.
  • Her SS symptoms included polyarthritis, lymphadenopathy, and Hashimoto thyroiditis, but notably lacked overt sicca syndrome.

Findings:

  • Standard treatments with moderate-dose steroids and azathioprine were ineffective for her MG.
  • A treatment regimen involving monthly alternating methylprednisolone and oral cyclophosphamide led to rapid and positive response within weeks.

Implications:

  • SS should be considered in the differential diagnosis of glomerulonephritis, particularly MG, even in the absence of classic sicca symptoms.
  • The combination therapy of alternating methylprednisolone and cyclophosphamide offers an effective and well-tolerated treatment option for refractory MG in SS patients.
  • Early consideration and appropriate management of SS-associated glomerulonephritis are crucial to prevent renal insufficiency.

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