Sjögren's syndrome with bipolar disorder, case report

Sjögren's syndrome is an autoimmune disease affecting exocrine glands and other organs. At the onset of the disease and during its course, it most commonly manifests as neuropsychiatric symptoms, most frequently, depression and anxiety. However, the association with bipolar disorder seems rare and not frequently documented.

Our case report presents a 43-year-old male complaining from neuropsychiatric symptoms including but not limited to periods of elevated mood, increased energy, headaches. Examination revealed xerophthalmia and xerostomia, thus Sjogren's Syndrome was diagnosed. A psychiatric consultation further diagnosed the patient with Bipolar Disorder. Successful treatment consisted of Carbamazepine and Azathioprine.

People with immunological diseases like Sjogren's Syndrome have a higher chance of developing Bipolar Disorder with an unclear etiology. Clinical symptoms, MRI findings, and cerebral fluid analysis can lead to a proper diagnosis. Treatments include usual treatment for Sjogren's such as corticosteroids and immunosuppressants, in the addition of mood stabilizers for Bipolar.

Psychiatry assessments should be done systematically in patients with autoimmune diseases to avoid delays in diagnosis and to make better treatment decisions.