A case of primary Sjogren's syndrome accompanied by transverse myelitis

Here we report a case of Sjogren's syndrome (SS) accompanied by transverse myelitis. A 46-year-old woman with 7-year history of primary SS was admitted to Tokyo Metropolitan Ohtsuka Hospital in September 1997 because of muscular weakness in lower extremities. She had had a low grade fever, numbness, and pain in bilateral lower extremities since July 1992. Neurological examination revealed transverse myelopathy at the level of Th 4, and peripheral neuropathy in lower extremities. Cerebrospinal fluid analysis showed slight elevation of protein and the cell count. A diagnosis of transverse myelitis and peripheral neuropathy presenting as neurologic manifestations of SS was made. Treatment was initiated with 30 mg of prednisolone, followed by improvement of fever and neurological findings. Although central nervous system complications of SS have been presented in Western countries, little information is available about Japanese patients. To our knowledge, this is the second case report which describes the occurrence of transverse myelitis in Japanese patients with SS.