White matter abnormalities in primary Sjögren syndrome

Area of Science:

• Neurology
• Rheumatology
• Radiology

Background:

• Primary Sjögren syndrome (SS) is a systemic autoimmune disease primarily affecting exocrine glands.
• Neurological involvement is a common complication of primary SS, with white matter abnormalities (WMA) frequently observed on neuroimaging.
• Understanding the characteristics and predictors of WMA in primary SS is crucial for diagnosis and management.

Purpose of the Study:

• To characterize patients with primary SS and WMA.
• To identify the prevalence and types of WMA in a specialist SS unit.
• To determine predictors of WMA in primary SS patients with neurological symptoms.

Main Methods:

• Retrospective analysis of 321 primary SS patients meeting 2002 classification criteria.
• Review of neuroimaging studies in patients with neurological symptoms.
• Neurological evaluation to assess for multiple sclerosis (MS) using McDonald criteria.

Main Results:

• WMA were found in 16% of patients with neurological symptoms (25/51).
• Vascular WMA were more common (80%) than inflammatory/demyelinating (MS-like) lesions (20%).
• Hypertension and HDL-c levels were independent predictors of WMA in primary SS.

Conclusions:

• WMA are prevalent in primary SS patients with neurological symptoms.
• Vascular changes are the predominant type of WMA.
• Hypertension and dyslipidemia (low HDL-c) are significant risk factors for WMA in primary SS.