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Published on: October 13, 2023
Chronic inflammatory demyelinating polyradiculoneuropathy associated with Sjögren`s syndrome in a child
Nurşah Yeniay Süt1, Ayşe Tuğba Kartal1, Şeyma Ertem2
1Department of Pediatric Neurology, Ankara University Faculty of Medicine, Ankara.
Insights
This case study presents the first pediatric patient diagnosed with both Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) and Sjögren's syndrome. Early diagnosis and treatment led to significant recovery of motor function.
Area of Science:
- Neurology
- Immunology
- Pediatrics
Background:
- Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a neurological disorder affecting the peripheral nervous system.
- CIDP is often associated with polyautoimmunity, indicating a complex immune system involvement.
Observation:
- A 13-year-old boy presented with a six-month history of progressive gait disturbance and distal lower limb weakness.
- Clinical examination revealed diminished reflexes, muscle weakness and atrophy, drop foot, and normal sensation.
- Electrophysiological studies confirmed a diagnosis of CIDP.
Findings:
- The patient was also diagnosed with Sjögren's syndrome and autoimmune sialadenitis, evidenced by positive antinuclear antibodies and anti-Ro52 antibodies.
- This represents the first reported pediatric case of coexisting CIDP and Sjögren's syndrome.
Implications:
- The findings suggest a potential link between CIDP and Sjögren's syndrome in pediatric patients.
- Investigating pediatric CIDP cases for underlying autoimmune conditions like Sjögren's syndrome is recommended.
- Prompt treatment with intravenous immunoglobulin and corticosteroids resulted in improved motor function and ambulation.
Background:
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a peripheral nervous system disease associated with polyautoimmunity.
Case:
We report a previously healthy 13-year old boy who was referred to our outpatient clinic with gait disturbance and distal lower limb weakness that had been increasing for six months. The patient had decreased deep tendon reflexes in the upper extremities and absence in the lower extremities, reduced muscle strength in the distal and proximal lower extremities, muscle atrophy, drop foot, and normal pinprick sensations. The patient was diagnosed with CIDP as a result of clinical findings and electrophysiological studies. Autoimmune diseases and infectious agents were investigated in terms of triggering CIDP. Although there was no clinical sign other than polyneuropathy, he was also diagnosed with Sjögren`s syndrome due to positive antinuclear antibodies and antibodies against Ro52, and with autoimmune sialadenitis. After six months of monthly intravenous immunoglobulin and oral methylprednisolone treatments, the patient was able to dorsiflex his left foot and walk without support.
Conclusions:
To our knowledge, our case is the first pediatric case with the coexistence of Sjögren`s syndrome and CIDP. Therefore, we suggest investigating children with CIDP in terms of underlying autoimmune diseases such as Sjögren`s syndrome.
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