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Case Reports in Immunology
Volume 2012 (2012), Article ID 186320, 3 pages
http://dx.doi.org/10.1155/2012/186320
Case Report

Intravenous Immunoglobulin and Mycophenolate Mofetil for Long-Standing Sensory Neuronopathy in Sjögren's Syndrome

1Clinica Medica, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche & Ospedali Riuniti, Via Tronto 10, 60126 Ancona, Italy
2U.O. di Medicina-LPA, Presidio di Loreto, 66025 Loreto, Italy
3U.O. di Radiodiagnostica, Ospedale di Casarano, 73042 Lecce, Italy
4Clinica Neurologica, Dipartimento di Medicina Sperimentale e Clinica, Polo Didattico Scientifico, Università Politecnica delle Marche & Azienda Ospedali Riuniti, Via Tronto 10, 60126 Ancona, Italy

Received 2 September 2012; Accepted 31 October 2012

Academic Editors: N. Kutukculer, Y. Nozaki, B. Sarov, and A. Vojdani

Copyright © 2012 Maria Giovanna Danieli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Sensory neuronopathy is described in association with the Sjögren's syndrome (SS). We studied a 55-year-old woman with a 4-year history of progressive asymmetric numbness, distal tingling, and burning sensation in upper and lower limbs. In a few months, she developed ataxia with increased hypoanaesthesia. Electrodiagnostic tests revealed undetectable distal and proximal sensory nerve action potential in upper and lower limbs. Cervical spine magnetic resonance showed a signal hyperintensity of posterior columns. Previous treatment with high-dose glucocorticoids and azathioprine was ineffective. A combined treatment with intravenous immunoglobulin and mycophenolate mofetil was followed by a progressive and persistent improvement. This case documented the efficacy and the safety of the coadministration of intravenous immunoglobulin and mycophenolate mofetil in sensory neuronopathy associated with SS refractory to conventional immunosuppressive therapy.