A 45-year-old female with a history of @entity936 presented with chronic progressive disturbance of her right finger extension, bilateral foot drops, and @entity809 in the left lower leg. On admission, neurological examination revealed @entity3140 and bilateral lower limbs, and @entity809 in the distal outer portions of the bilateral lower legs. Her vibration sensation was moderately diminished in both lower legs. @entity425 ranging from moderate to severe was predominantly found in the muscles innervated by the radial (r > l), medial (r > l), ulnar (r > l), deep peroneal (r     l), tibial (r < l), and medial planter nerves (r < l). Nerve conduction study showed asymmetrical @entity16 , while chronic neurogenic changes were observed on needle electromyography. Cerebrospinal fluid analysis results were unremarkable, except for an elevated IgG index (1.53) and the presence of oligoclonal IgG bands. Seropositive anti- @entity6540 antibody and histological findings of the biopsied minor salivary gland, as well as the lack of other @entity2597 , indicated primary Sj  gren syndrome (SjS). A left sural nerve biopsy showed @entity353 in the myelinated fibers within @entity2901 , mild infiltration of @entity405 -positive T lymphocytes around small vessels, and no fibrinoid @entity39 in the arteries. From these findings, the diagnosis of motor-dominant multiple @entity4216 associated with primary SjS was made. Therapy that comprised a single course of intravenous (IV) @entity1667 (1   g for 3 days), followed by oral @entity617 (60   mg/day) with gradual tapering, resulted in no amelioration of her symptoms. She then received IV immunoglobulin (0.4   mg/kg/day for 5 days), which resulted in moderate improvement in the strength of several muscles and a reduction of CSF IgG index (0.89). A wide variety of @entity1897 are documented in primary SjS. However, the present case is unique in the symptoms of chronic progressive, motor-dominant, multiple mononeuritic phenotype.

[A case of chronic progressive motor-dominant multiple XXXX associated with primary Sj  gren's syndrome].

@entity1667 :: ('MESH:D008775', 'Chemical') :: ['methylprednisolone'] @entity2597 :: ('MESH:D003240', 'Disease') :: ['connective tissue disorders'] @entity353 :: ('MESH:D015431', 'Disease') :: ['inhomogeneous reductions'] @entity6540 :: ('6737', 'Gene') :: ['SS-A'] @entity39 :: ('MESH:D009336', 'Disease') :: ['necrosis'] @entity809 :: ('MESH:D010292', 'Disease') :: ['dysesthesia'] @entity16 :: ('MESH:D009422', 'Disease') :: ['axonal neuropathy'] @entity425 :: ('MESH:D018908', 'Disease') :: ['Weakness'] @entity3140 :: ('MESH:D038062', 'Disease') :: ['decreased tendon reflex in the right upper limb'] @entity1897 :: ('MESH:D010523', 'Disease') :: ['peripheral nerve complications'] @entity936 :: ('MESH:D015352', 'Disease') :: ['dry eyes'] @entity4216 :: ('MESH:D020422', 'Disease') :: ['mononeuritis'] @entity2901 :: ('MESH:D005207', 'Disease') :: ['fascicules'] @entity405 :: ('925', 'Gene') :: ['CD8'] @entity617 :: ('MESH:D011239', 'Chemical') :: ['prednisolone']
@entity4216 :: (MESH:D020422,Disease) :: ['mononeuritis']
