THU0276 CHARACTERISTICS OF NEUROLOGIC INVOLVEMENT AND ITS RELATED FACTORS IN PRIMARY SJÖGREN SYNDROME 
Authors: minli qiu, Yutong Jiang, Wen Yang, Jieruo Gu
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Neurological manifestations seem common in primary Sjögren's syndrome (pSS) but their reported prevalences vary in Chinese. And few studies reveal if the disease activity is associated with neurological involvement. <h3>Objectives:</h3> To analyze the clinical neurological manifestations of primary Sjögren syndrome(pSS), and to evaluate the relationship with disease activity. <h3>Methods:</h3> 112 patients(7 male, 105 female) who fulfilled the 2002 American-European Consensus Group criteria for pSS were enrolled in the study. For each patient, the clinical features were evaluated by medical data including clinical, laboratory and immunologic data, and neurological examinations including electromyography, magnetic resonance imaging, cerebrospinal fluid, and electroencephalogram. Statistical methods used were t-test, chi-square test and Logistic regression. <h3>Results:</h3> Data at inclusion were available for 112 patients, whose mean age was 55±10 years. Neurological involvement was noted in 19.6(22/112) patients, including 17(15.2%) with peripheral nervous system(PNS) manifestations, 3(2.8%) with central nervous system (CNS) manifestations and 2(1.8%) with both PNS and CNS involvements. Optic neuritis and trigeminal neuralgia were revealed frequently in cranial neuropathy. Anti-aquaporin 4 antibody was detected in two patients with optic neuritis. The clinical spectrum of peripheral neuropathies encountered in Sjögren's syndrome patients was wide with sensory neuropathies being the most common. Tibial nerve, peroneal nerve and sural nerve were the most likely involved and lower limb involvement accounted for 68.4%(13/19). The frequency of Raynaud's phenomenon was significantly higher[31.8%(7/22) vs 4.4%(4/90), P&lt;0.01] as well as acroanesthesia(72.7% vs 8.9%, P&lt;0.01) in pSS with neurological involvement than in pSS without neuropathy. The median values of EULAR Sjögren's syndrome disease activity index(ESSDAI) were 5.6(range 2.6-7.6) and 3.2(range 1.4-5.2) in the NS and non-NS groups respectively(P&lt;0.01). We found a significant rise of neuropathy risk associated with Raynaud's phenomenon(relative risk 9.365, 95%CI 3.191∼40.093,P=0.003) and ESSDAI(relative risk 1.628, 95%CI 1.169∼1.969, P=0.001). Elevated liters of rheumatoid factor(P&lt;0.05) and ANA(P&lt;0.01) were common in patients with neuropathy. <h3>Conclusion:</h3> Neuropathy is not a rare manifestation of pSS. Prevalence of neurological involvement in pSS is 19.6%. Raynauds phenomenon and high disease activity may be the risk factors for neuropathy. Autoantibodies might contribute to the injury of the nervous system. <h3>References:</h3> [1] Jamilloux Y, Magy L, Hurtevent JF, et al. Immunological profiles determine neurological involvement in Sjögren's syndrome. Eur J Intern Med 2014;25:177–81. [2] Ramos-Casals M, Brito-Zeron P, Solans R, et al. Systemic involvement in primary Sjögren's syndrome evaluated by the EULAR-SS disease activity index. Rheumatology (Oxford) 2014;53:321–31. [3] Teixeira F, Moreira I, Silva AM, et al. Neurological involvement in Primary Sjögren Syndrome. Acta Reumatol Port. 2013 Jan-Mar;38(1):29-36. <h3>Disclosure of Interests:</h3> None declared