Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Primary Sjgren's Syndrome-Associated Non Ataxic Sensory Neuropathies and Sensorimotor Neuropathies Are Characterized by Distinctive Immunological Profiles.

Sene2,  Damien, Jallouli2,  Moez, Lefaucheur1,  Jean-Pascal, Saadoun2,  David, Maisonobe2,  Thierry, Haroche2,  Julien, Diemert2,  Marie-Claude

Henri-Mondor Hospital
Pitie-Salpetriére Hospital

Objective:

To characterize the relationship between primary Sjögren's Syndrome (pSS)-associated peripheral neuropathies (PN) and markers of B cell monoclonal proliferation and chronic activation.

Patients and Methods:

120 consecutive patients presenting with a definite pSS were included. Serum markers of chronic B-cell activation included auto-antibodies and hypergammaglobulinemia. Monoclonal B-cell proliferation markers included mixed cryoglobulin, monoclonal gammopathy, abnormal k/l free light chain (FLC) ratio or B-cell non Hodgkin lymphoma (B-NHL).

Results:

A definite PN was present in 30 patients (25%) including 7 patients with a sensorimotor neuropathy (23%), 3 patients with an ataxic sensory neuropathy (10%) and 20 patients with a non-ataxic sensory neuropathy (67%). Patients with a sensorimotor neuropathy differed from those without PN by higher rates of monoclonal B-cell proliferation markers, i.e. mixed cryoglobulin (57% vs. 11%; P=0.008), monoclonal gammopathy (71% vs. 17%; P=0.004), higher FLC ratio (2.7±1.5 vs. 1.7±1.8; P=0.024) and B-NHL (57% vs. 3%; P<0.001). Patients with non-ataxic sensory neuropathy were featured by a higher age (57.5±10.7 vs. 48.7±14.3 years; P=0.007), a more frequent CNS involvement (15% vs. 2%; P=0.04) and a lower prevalence of chronic B-cell activation serum markers, i.e., ANA (60% vs. 90%; P=0.003), anti-SSA (Ro) (40% vs. 72%; P=0.009), anti-SSB (La) (15% vs. 41%; P=0.039), RF (37% vs. 67%; P=0.02), and hypergammaglobulinemia (35% vs. 64%; P=0.023). In multivariate analysis, a sensorimotor neuropathy was associated with the presence of B-NHL (OR=39.0; P<0.001), whereas a non-ataxic sensory neuropathy was associated with the presence of a CNS involvement (OR=17.0; P=0.025) and ANA (OR=0.07; P<0.001).

Conclusion:

Up to 25% of pSS-patients presented with peripheral neuropathy, which was predominantly a sensory neuropathy. Distinctive immunological profiles were found according to the type of SS-associated neuropathy, as non-ataxic sensory neuropathy was hallmarked by a low prevalence of B-cell activation markers and sensorimotor neuropathy by a high prevalence of B-cell monoclonal proliferation markers

To cite this abstract, please use the following information:
Sene, Damien, Jallouli, Moez, Lefaucheur, Jean-Pascal, Saadoun, David, Maisonobe, Thierry, Haroche, Julien, et al; Primary Sjgren's Syndrome-Associated Non Ataxic Sensory Neuropathies and Sensorimotor Neuropathies Are Characterized by Distinctive Immunological Profiles. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1911
DOI: 10.1002/art.29676

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