You’ve got to know the neurologic phenotypes.
What are they? Let’s see how well you know them ⬇️
What are they? Let’s see how well you know them ⬇️
What’s the most common neurologic manifestation?
Distal symmetric polyneuropathy - usually axonal and sensory, but can be sensorimotor.
▫️EMG is critical for diagnosis (see 👇) and to differentiate from other forms of neuropathy.
▫️Consider skin biopsy if negative for small fiber.
DOI: 10.1111/ene.15555
▫️EMG is critical for diagnosis (see 👇) and to differentiate from other forms of neuropathy.
▫️Consider skin biopsy if negative for small fiber.
DOI: 10.1111/ene.15555
What type is highly suggestive of Sjögren’s? Clue: and also anti-Hu
Sensory neuronopathy - it carries an interesting DDx (anti-Hu, B6 toxicity, platinum chemo, etc), but Sjögren’s deserves to be at the top of the list of considerations.
🔑 - just know that Neuro manifestations precede typical Sjögren’s symptoms at 2:1.
DOI: 10.1002/mus.24943
🔑 - just know that Neuro manifestations precede typical Sjögren’s symptoms at 2:1.
DOI: 10.1002/mus.24943
What antibody has to be checked in someone with Sjögren’s-related myelitis? 🧐
AQP4 - LETM is usually the radiographic phenotype of Sjögren’s-related myelitis, and a recent lit review showed 89% were AQP4+❗️
Also 🔑: if one autoimmune sz doesn’t explain the full clinical picture, consider another. Might change mgmt.
DOI: 10.1016/j.semarthrit.2010.05.005
Also 🔑: if one autoimmune sz doesn’t explain the full clinical picture, consider another. Might change mgmt.
DOI: 10.1016/j.semarthrit.2010.05.005
Now if 20% of 4M have Sjögren’s = 800k people! 🤯
How many doctors are dedicated to studying and caring for people with these neurological complications? Good question, I can only name a few.
It starts with you. #advocacyinmedicine #AANAM @AANmember #rheumtwitter
How many doctors are dedicated to studying and caring for people with these neurological complications? Good question, I can only name a few.
It starts with you. #advocacyinmedicine #AANAM @AANmember #rheumtwitter
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