{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:29:24Z","timestamp":1767140964908,"version":"build-2238731810"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T00:00:00Z","timestamp":1659312000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T00:00:00Z","timestamp":1659312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Rheumatol"],"published-print":{"date-parts":[[2022,10]]},"DOI":"10.1007\/s10067-022-06294-w","type":"journal-article","created":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T10:08:05Z","timestamp":1659348485000},"page":"3237-3243","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of early-onset myasthenia gravis and primary Sj\u00f6gren\u2019s syndrome: a case-based narrative review"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1217-1555","authenticated-orcid":false,"given":"Marc","family":"Hartert","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7265-2567","authenticated-orcid":false,"given":"Balint","family":"Melcher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6177-3985","authenticated-orcid":false,"given":"Martin","family":"Huertgen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,8,1]]},"reference":[{"key":"6294_CR1","doi-asserted-by":"publisher","first-page":"2570","DOI":"10.1056\/NEJMra1602678","volume":"375","author":"NE Gilhus","year":"2016","unstructured":"Gilhus NE (2016) Myasthenia gravis. N Engl J Med 375:2570\u20132581","journal-title":"N Engl J Med"},{"key":"6294_CR2","doi-asserted-by":"publisher","first-page":"362","DOI":"10.3109\/08916934.2015.1030614","volume":"48","author":"A Nacu","year":"2015","unstructured":"Nacu A, Andersen JB, Lisnic V, Owe JF, Gilhus NE (2015) Complicating autoimmune diseases in myasthenia gravis: a review. Autoimmunity 48:362\u2013368","journal-title":"Autoimmunity"},{"key":"6294_CR3","doi-asserted-by":"publisher","first-page":"939","DOI":"10.3389\/fneur.2020.00939","volume":"11","author":"X Li","year":"2020","unstructured":"Li X, Zhao Y, Liao Q, Da Y (2020) Myasthenia gravis coexisting with primary Sj\u00f6gren\u2019s syndrome: report of three cases and literature review. Front Neurol 11:939","journal-title":"Front Neurol"},{"key":"6294_CR4","doi-asserted-by":"publisher","first-page":"412","DOI":"10.3109\/08916934.2015.1031890","volume":"48","author":"A Evoli","year":"2015","unstructured":"Evoli A, Caliandro P, Iorio R, Alboini PE, Damato V, LaTorre G et al (2015) Polyautoimmunity in patients with myasthenia gravis: a single-center experience. Autoimmunity 48:412\u2013417","journal-title":"Autoimmunity"},{"key":"6294_CR5","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1056\/NEJMcp1702514","volume":"378","author":"X Mariette","year":"2018","unstructured":"Mariette X, Criswell LA (2018) Primary sj\u00f6gren\u2019s syndrome. N Engl J Med 378:931\u2013939","journal-title":"N Engl J Med"},{"key":"6294_CR6","doi-asserted-by":"crossref","unstructured":"Tian Y, Yang H, Liu N, Li Y, Chen J (2021) Advances in pathogenesis of Sj\u00f6gren\u2019s syndrome. J Immunol Res 5928232","DOI":"10.1155\/2021\/5928232"},{"key":"6294_CR7","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1586\/1744666X.2014.900441","volume":"10","author":"D Zhou","year":"2014","unstructured":"Zhou D, McNamara NA (2014) Macrophages: important players in primary Sj\u00f6gren\u2019s syndrome? Expert Rev Clin Immunol 10:513\u2013520","journal-title":"Expert Rev Clin Immunol"},{"key":"6294_CR8","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1111\/sji.12079","volume":"78","author":"A Karabiyik","year":"2013","unstructured":"Karabiyik A, Peck AB, Nguyen CQ (2013) The important role of T cells and receptor expression in Sj\u00f6gren\u2019s syndrome. Scand J Immunol 78:157\u2013166","journal-title":"Scand J Immunol"},{"key":"6294_CR9","doi-asserted-by":"publisher","first-page":"1935","DOI":"10.1038\/labinvest.3780203","volume":"80","author":"SC van Blokland","year":"2000","unstructured":"van Blokland SC, Wierenga-Wolf AF, van Helden-Meeuwsen CG, Drexhage HA, Hooijkaas H, van de Merwe JP et al (2000) Professional antigen presenting cells in minor salivary glands in Sj\u00f6gren\u2019s syndrome: potential contribution to the histopathological diagnosis? Lab Invest 80:1935\u20131941","journal-title":"Lab Invest"},{"key":"6294_CR10","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1056\/NEJM200108023450506","volume":"345","author":"A Davidson","year":"2001","unstructured":"Davidson A, Diamond B (2001) Autoimmune diseases. N Engl J Med 345:340\u2013350","journal-title":"N Engl J Med"},{"key":"6294_CR11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0032487","volume":"7","author":"C Sardu","year":"2012","unstructured":"Sardu C, Cocco E, Mereu A, Massa R, Cuccu A, Marrosu MG et al (2012) Population based study of 12 autoimmune diseases in Sardinia, Italy: prevalence and comorbidity. PLoS ONE 7:e32487","journal-title":"PLoS ONE"},{"key":"6294_CR12","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1111\/j.1749-6632.2010.05818.x","volume":"1214","author":"M Waterfield","year":"2010","unstructured":"Waterfield M, Anderson MS (2010) Clues to immune tolerance: the monogenic autoimmune syndromes. Ann N Y Acad Sci 1214:138\u2013155","journal-title":"Ann N Y Acad Sci"},{"key":"6294_CR13","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1111\/j.1749-6632.2012.06774.x","volume":"1274","author":"JF Bach","year":"2012","unstructured":"Bach JF (2012) The etiology of autoimmune diseases: the case of myasthenia gravis. Ann N Y Acad Sci 1274:33\u201339","journal-title":"Ann N Y Acad Sci"},{"key":"6294_CR14","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1038\/nrendo.2013.161","volume":"9","author":"A Zhernakova","year":"2013","unstructured":"Zhernakova A, Withoff S, Wijmenga C (2013) Clinical implications of shared genetics and pathogenesis in autoimmune diseases. Nat Rev Endocrinol 9:646\u2013659","journal-title":"Nat Rev Endocrinol"},{"key":"6294_CR15","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1016\/j.jaut.2013.12.001","volume":"52","author":"N Avidan","year":"2014","unstructured":"Avidan N, Le Panse R, Berrih-Aknin S, Miller A (2014) Genetic basis of myasthenia gravis\u2014a comprehensive review. J Autoimmun 52:146\u2013153","journal-title":"J Autoimmun"},{"key":"6294_CR16","doi-asserted-by":"publisher","first-page":"1062","DOI":"10.1136\/ard.2004.029066","volume":"64","author":"MN Lazarus","year":"2005","unstructured":"Lazarus MN, Isenberg DA (2005) Development of additional autoimmune diseases in a population of patients with primary Sj\u00f6gren\u2019s syndrome. Ann Rheum Dis 64:1062\u20131064","journal-title":"Ann Rheum Dis"},{"key":"6294_CR17","volume":"2012","author":"A Rojas-Villarraga","year":"2012","unstructured":"Rojas-Villarraga A, Amaya-Amaya J, Rodriguez-Rodriguez A, Mantilla RD, Anaya JM (2012) Introducing polyautoimmunity: secondary autoimmune diseases no longer exist. Autoimmune Dis 2012:254319","journal-title":"Autoimmune Dis"},{"key":"6294_CR18","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1007\/s12016-018-8709-9","volume":"56","author":"JM Anaya","year":"2019","unstructured":"Anaya JM, Restrepo-Jim\u00e9nez P, Rodr\u00edguez Y, Rodr\u00edguez-Jim\u00e9nez M, Acosta-Ampudia Y, Monsalve DM et al (2019) Sj\u00f6gren\u2019s syndrome and autoimmune thyroid disease: two sides of the same coin. Clin Rev Allergy Immunol 56:362\u2013374","journal-title":"Clin Rev Allergy Immunol"},{"key":"6294_CR19","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.jns.2017.08.010","volume":"381","author":"S Duarte","year":"2017","unstructured":"Duarte S, Santos E, Martins J, Martins Silva A, Lopes C, Gon\u00e7alves G et al (2017) Myasthenia gravis with systemic and neurological polyautoimmunity. J Neurol Sci 381:39\u201340","journal-title":"J Neurol Sci"},{"key":"6294_CR20","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2020.102498","volume":"19","author":"M Garibaldi","year":"2020","unstructured":"Garibaldi M, Fionda L, Vanoli F, Leonardi L, Loreti S, Bucci E et al (2020) Muscle involvement in myasthenia gravis: expanding the clinical spectrum of Myasthenia-Myositis association from a large cohort of patients. Autoimmun Rev 19:102498","journal-title":"Autoimmun Rev"},{"key":"6294_CR21","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000535","volume":"6","author":"N Uchio","year":"2018","unstructured":"Uchio N, Taira K, Ikenaga C, Kadoya M, Unuma A, Yoshida K et al (2018) Inflammatory myopathy with myasthenia gravis: thymoma association and polymyositis pathology. Neurol Neuroimmunol Neuroinflamm 6:e535","journal-title":"Neurol Neuroimmunol Neuroinflamm"},{"key":"6294_CR22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jaut.2014.05.001","volume":"52","author":"S Berrih-Aknin","year":"2014","unstructured":"Berrih-Aknin S (2014) Myasthenia gravis: paradox versus paradigm in autoimmunity. J Autoimmun 52:1\u201328","journal-title":"J Autoimmun"},{"key":"6294_CR23","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1212\/WNL.0000000000002790","volume":"87","author":"DB Sanders","year":"2016","unstructured":"Sanders DB, Wolfe GI, Benatar M, Evoli A, Gilhus NE, Illa I et al (2016) International consensus guidance for management of myasthenia gravis: executive summary. Neurology 87:419\u2013425","journal-title":"Neurology"},{"key":"6294_CR24","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1111\/nyas.13537","volume":"1412","author":"DB Sanders","year":"2018","unstructured":"Sanders DB, Wolfe GI, Narayanaswami P; MGFA Task Force on MG Treatment Guidance (2018) Developing treatment guidelines for myasthenia gravis. Ann N Y Acad Sci 1412:95\u2013101","journal-title":"Ann N Y Acad Sci"},{"key":"6294_CR25","doi-asserted-by":"crossref","unstructured":"Ramos-Casals M, Brito-Zer\u00f3n P, Bombardieri S, Bootsma H, De Vita S, D\u00f6rner T, et al; EULAR-Sj\u00f6gren Syndrome Task Force Group (2020) EULAR recommendations for the management of Sj\u00f6gren\u2019s syndrome with topical and systemic therapies. Ann Rheum Dis 79:3-18","DOI":"10.1136\/annrheumdis-2019-216114"},{"key":"6294_CR26","doi-asserted-by":"crossref","unstructured":"Wolfe GI, Kaminski HJ, Aban IB, Minisman G, Kuo HC, Marx A, et al; MGTX Study Group (2016) Randomized trial of thymectomy in myasthenia gravis. N Engl J Med 375:511-22","DOI":"10.1056\/NEJMc1611704"},{"key":"6294_CR27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2020.116690","volume":"411","author":"T Litchman","year":"2020","unstructured":"Litchman T, Roy B, Kumar A, Sharma A, Njike V, Nowak RJ (2020) Differential response to rituximab in anti-AChR and anti-MuSK positive myasthenia gravis patients: a single-center retrospective study. J Neurol Sci 411:116690","journal-title":"J Neurol Sci"},{"key":"6294_CR28","doi-asserted-by":"publisher","first-page":"2043","DOI":"10.1093\/rheumatology\/kez562","volume":"59","author":"N Mena-V\u00e1zquez","year":"2020","unstructured":"Mena-V\u00e1zquez N, Fern\u00e1ndez-Nebro A, Pego-Reigosa JM, Galindo M, Melissa-Anzola A, Uriarte-Isacelay E et al (2020) Hydroxychloroquine is associated with a lower risk of polyautoimmunity: data from the RELESSER Registry. Rheumatology (Oxford) 59:2043\u20132051","journal-title":"Rheumatology (Oxford)"},{"key":"6294_CR29","first-page":"849","volume":"67","author":"O Varan","year":"2015","unstructured":"Varan O, Kucuk H, Tufan A (2015) Myasthenia gravis due to hydroxychloroquine. Reumatismo 67:849","journal-title":"Reumatismo"},{"key":"6294_CR30","doi-asserted-by":"publisher","first-page":"1290","DOI":"10.1007\/s00415-011-6335-z","volume":"259","author":"M Jallouli","year":"2012","unstructured":"Jallouli M, Saadoun D, Eymard B, Leroux G, Haroche J, Le Thi HD et al (2012) The association of systemic lupus erythematosus and myasthenia gravis: a series of 17 cases, with a special focus on hydroxychloroquine use and a review of the literature. J Neurol 259:1290\u20131297","journal-title":"J Neurol"},{"key":"6294_CR31","doi-asserted-by":"crossref","unstructured":"The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes (1999) Arthritis Rheum 42:599\u2013608","DOI":"10.1002\/1529-0131(199904)42:4<599::AID-ANR2>3.0.CO;2-F"},{"key":"6294_CR32","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1080\/25785826.2020.1770947","volume":"43","author":"Y Fujieda","year":"2020","unstructured":"Fujieda Y (2020) Diversity of neuropsychiatric manifestations in systemic lupus erythematosus. Immunol Med 43:135\u2013141","journal-title":"Immunol Med"}],"updated-by":[{"DOI":"10.1007\/s10067-022-06328-3","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T00:00:00Z","timestamp":1660176000000}}],"container-title":["Clinical Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10067-022-06294-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10067-022-06294-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10067-022-06294-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,19]],"date-time":"2022-09-19T10:31:20Z","timestamp":1663583480000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10067-022-06294-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,1]]},"references-count":32,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["6294"],"URL":"https:\/\/doi.org\/10.1007\/s10067-022-06294-w","relation":{},"ISSN":["0770-3198","1434-9949"],"issn-type":[{"value":"0770-3198","type":"print"},{"value":"1434-9949","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,1]]},"assertion":[{"value":"4 May 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 July 2022","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 July 2022","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 August 2022","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 August 2022","order":5,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":6,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1007\/s10067-022-06328-3","URL":"https:\/\/doi.org\/10.1007\/s10067-022-06328-3","order":8,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All procedures depicted in this case were in accordance with the ethical standards of the institutional and\/or national research committee(s) and with the Helsinki Declaration (as revised in 2013). Written informed consent was obtained from the patient for publication of this case report and accompanying images.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"None.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}