Peripheral neuropathy and health-related quality of life in patients with primary Sjögren's syndrome: a preliminary report

Rheumatol Int. 2020 Aug;40(8):1267-1274. doi: 10.1007/s00296-020-04543-2. Epub 2020 Mar 14.

Abstract

Sjögren's syndrome (SS) is a chronic autoimmune disease with a wide spectrum of possible organ involvement. Peripheral (PNS) and central nervous system (CNS)-related symptoms may occur in the course of the disease. The aim of this study was to compare the health-related quality of life (HR-QOL) in SS patients with and without peripheral neuropathy. The study involved 50 patients with primary Sjögren's syndrome (pSS). All patients underwent neurological clinical examination followed by nerve conduction studies (NCS) and rheumatological examination. Thirty-six-item Short Form Health Survey (SF-36) was used for evaluating HR-QOL. To assess pSS activity, the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) and EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) were used. For the assessment of clinical disability due to peripheral neuropathy, the Overall Disability Sum Score scale (ODSS) was used. Additional evaluation of pain was performed with the use of the Visual Analogue Scale (VAS) and a semistructured interview. Twenty-three (46%) patients were diagnosed with peripheral neuropathy. The most common PNS manifestation was sensorimotor neuropathy (47%). Neurological symptoms preceded the diagnosis of pSS in eight patients. The following domains of the SF-36 form were significantly lower scored by patients with peripheral nervous system involvement: role-physical [0 (0-100) vs. 75 (0-100)], role-emotional [67 (0-100) vs. 100 (0-100)], vitality [40 (10-70) vs. 50 (20-75)], bodily pain [45 (10-75) vs. 55 (0-100)], and general health [20 (5-50) vs. 30 (0-50)] (p ≤ 0.05). Our study showed that peripheral neuropathy was a common organ-specific complication in SS patients. In pSS patients, coexisting neurological involvement with symptoms such as pain and physical disability may be responsible for diminished HR-QOL.

Keywords: Autoimmune neuropathy; Health-related quality of life; Patient-reported outcomes; Peripheral nervous system involvement; Sjögren’s syndrome.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Cross-Sectional Studies
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Peripheral Nervous System Diseases / etiology*
  • Peripheral Nervous System Diseases / psychology
  • Quality of Life*
  • Severity of Illness Index
  • Sjogren's Syndrome / complications*
  • Sjogren's Syndrome / psychology
  • Surveys and Questionnaires