{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T20:01:42Z","timestamp":1786478502216,"version":"build-2736575974"},"reference-count":14,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,5,10]]},"abstract":"<jats:p>There are only six cases in literature that describe development of dystonia with Sjogren\u2019s syndrome (SS). We describe a case of a 43-year-old woman who presented with symptoms including movement disorder, sensory neurogenic bladder, sensory loss and neuropathic pain, migraine like headaches, musculoskeletal pain, Raynaud\u2019s phenomenon and dysautonomia. Symptoms started in 2000, with weakness that progressed to dystonia in 2003. Diagnostic work-up was inconclusive with negative inflammatory serologies, cerebrospinal fluid and MRI for many years. After patient developed sicca syndrome with dry eyes and mouth in 2009, her rheumatoid factor titre was elevated (550 IU\/mL), erythrocyte sedimentation rate, anti-Sjogrens syndrome-related antigen A (anti-Ro\/SSA) and anti-SSB\/La: anti-Sjogrens syndrome-related antigen B (anti-La\/SSB) became positive. Lip biopsy confirmed diagnosis of SS. She was diagnosed with primary SS with neurological involvement. Her symptoms responded well to intravenous methylprednisolone. Symptoms stabilised with trials of immune-suppressive therapy. This is a case that demonstrates the delay of diagnosing SS with preceding unique neurological association.<\/jats:p>","DOI":"10.1136\/bcr-2017-223468","type":"journal-article","created":{"date-parts":[[2018,6,4]],"date-time":"2018-06-04T08:56:59Z","timestamp":1528102619000},"page":"bcr-2017-223468","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Case of primary Sjogren\u2019s syndrome preceded by dystonia"],"prefix":"10.1136","volume":"2018","author":[{"given":"Kerime","family":"Ararat","sequence":"first","affiliation":[{"name":"Department of Medicine, Neurology, University of Massachusetts Medical School, Worcester, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idanis","family":"Berrios","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Massachusetts School of Medicine, Worcester, Massachusetts, 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