Sjögren Syndrome – Peripheral Neuropathy — SCE Neurology MCQ

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ModeratePeripheral Neuropathy & NeuromuscularSjögren Syndrome – Peripheral NeuropathySCE Neurology

A 50-year-old woman presents with a 6-month history of progressive bilateral leg weakness and numbness ascending to the mid-thighs. She also has Raynaud phenomenon, dry eyes, and dry mouth. NCS show a sensorimotor axonal polyneuropathy. She has positive anti-SSA (Ro) and anti-SSB (La) antibodies. Schirmer test is positive. What is the underlying diagnosis causing her neuropathy?

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Correct answer: E — Sjögren syndrome

Sjögren syndrome is an autoimmune exocrinopathy characterised by dry eyes (keratoconjunctivitis sicca), dry mouth (xerostomia), and systemic features. Peripheral neuropathy occurs in approximately 10–20% of cases and can be the presenting feature. Types include sensory axonal polyneuropathy (most common), small fibre neuropathy, sensory neuronopathy (ganglionopathy), mononeuritis multiplex, and cranial neuropathies (particularly trigeminal). Anti-SSA and anti-SSB antibodies and a positive Schirmer test support the diagnosis. A: Diabetes causes neuropathy but not sicca symptoms or SSA/SSB. C: RA causes neuropathy but has different antibodies. D: SLE has different features. E: Sarcoidosis can cause both but has different antibody profile.

Reference: EAN Neuropathy Guidelines; ABN Peripheral Neuropathy Guidelines