{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T16:15:07Z","timestamp":1773850507025,"version":"3.50.1"},"reference-count":21,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,12,5]]},"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:p>A 41-year-old woman presented with paresthesia and inability to walk for 7 days. She had history of fatigue, polyarthralgia and difficulty in swallowing food for the last 1\u2009year. She became edentulous over the last 5 years and wore dentures for the same. She appeared pale, emaciated and had oral thrush. She had areflexic quadriparesis with weakness more in lower limbs compared with upper limbs. With the initial diagnosis of Guillian-Barre syndrome, she was given five cycles of plasmapheresis following which there was a significant improvement in power. Sjogren\u2019s syndrome was suspected based on edentulous state in a middle-aged woman with multisystem involvement. Evaluation with Schirmer\u2019s test, parotid scintigraphy and labial minor salivary gland biopsy confirmed the diagnosis. She was treated with steroids following which a dramatic improvement in haemoglobin and total leucocyte count was noted. We report a varied presentation of primary Sjogren\u2019s syndrome.<\/jats:p>","DOI":"10.1136\/bcr-2019-231802","type":"journal-article","created":{"date-parts":[[2019,12,30]],"date-time":"2019-12-30T04:15:45Z","timestamp":1577679345000},"page":"e231802","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Primary Sjogren\u2019s syndrome: a great masquerader"],"prefix":"10.1136","volume":"12","author":[{"given":"Naveen","family":"Kumar","sequence":"first","affiliation":[{"name":"Medicine, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepanjali","family":"Surendran","sequence":"additional","affiliation":[{"name":"Medicine, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bheemanathi Hanuman","family":"Srinivas","sequence":"additional","affiliation":[{"name":"Pathology, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chanaveerappa","family":"Bammigatti","sequence":"additional","affiliation":[{"name":"Medicine, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,12,29]]},"reference":[{"key":"2025082803311024000_12.12.e231802.1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-205375"},{"key":"2025082803311024000_12.12.e231802.2","unstructured":"ACR Meeting Abstracts . Epidemiologic Subsets Drive a Differentiated Clinical and Immunological Presentation of Primary Sj\u00f6gren Syndrome: Analysis of 9302 Patients from the Big Data International Sj\u00f6gren Cohort [Internet]. Available: https:\/\/acrabstracts.org\/abstract\/epidemiologic-subsets-drive-a-differentiated-clinical-and-immunological-presentation-of-primary-sjogren-syndrome-analysis-of-9302-patients-from-the-big-data-international-sjogren-cohort\/ [Accessed 13 Sep 2018]."},{"key":"2025082803311024000_12.12.e231802.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)66990-5"},{"key":"2025082803311024000_12.12.e231802.4","doi-asserted-by":"publisher","DOI":"10.1097\/01.md.0000141099.53742.16"},{"key":"2025082803311024000_12.12.e231802.5","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.39.3.390"},{"key":"2025082803311024000_12.12.e231802.6","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh605"},{"key":"2025082803311024000_12.12.e231802.7","doi-asserted-by":"publisher","DOI":"10.1007\/s004150170135"},{"key":"2025082803311024000_12.12.e231802.8","doi-asserted-by":"publisher","DOI":"10.1016\/0030-4220(94)90143-0"},{"key":"2025082803311024000_12.12.e231802.9","doi-asserted-by":"publisher","DOI":"10.1177\/154405910808700411"},{"key":"2025082803311024000_12.12.e231802.10","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.27.5.416"},{"key":"2025082803311024000_12.12.e231802.11","doi-asserted-by":"crossref","DOI":"10.1186\/1472-6890-5-4","article-title":"Salivary changes and dental caries as potential oral markers of autoimmune salivary gland dysfunction in primary Sj\u00f6gren's syndrome","volume":"5","author":"Pedersen","year":"2005","journal-title":"BMC Clin Pathol"},{"key":"2025082803311024000_12.12.e231802.12","doi-asserted-by":"publisher","DOI":"10.1016\/S1079-2104(03)00224-5"},{"key":"2025082803311024000_12.12.e231802.13","doi-asserted-by":"crossref","unstructured":"Tob\u00f3n GJ , Pers J-O , Devauchelle-Pensec V , et al . Neurological Disorders in Primary Sj\u00f6gren\u2019s Syndrome. Autoimmune Dis 2012;2012.","DOI":"10.1155\/2012\/645967"},{"key":"2025082803311024000_12.12.e231802.14","doi-asserted-by":"crossref","first-page":"1782","DOI":"10.1111\/trf.13046","article-title":"Plasma exchange effectively removes 52- and 60-kDa anti-Ro\/SSA and anti-La\/SSB antibodies in pregnant women with congenital heart block","volume":"55","author":"Tonello","year":"2015","journal-title":"Transfusion"},{"key":"2025082803311024000_12.12.e231802.15","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1002\/pd.1970141019","article-title":"Successful outcome of pregnancy after treatment of maternal anti-Ro (SSA) antibodies with immunosuppressive therapy and plasmapheresis","volume":"14","author":"Van Der Leij","year":"1994","journal-title":"Prenat Diagn"},{"key":"2025082803311024000_12.12.e231802.16","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-200207000-00004"},{"key":"2025082803311024000_12.12.e231802.17","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0b013e3181b76ab5"},{"key":"2025082803311024000_12.12.e231802.18","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1002\/art.39859","article-title":"2016 American College of Rheumatology\/European League against rheumatism classification criteria for primary Sj\u00f6gren's syndrome: a consensus and data-driven methodology involving three international patient cohorts","volume":"69","author":"Shiboski","year":"2017","journal-title":"Arthritis Rheumatol"},{"key":"2025082803311024000_12.12.e231802.19","doi-asserted-by":"publisher","DOI":"10.1136\/ard.61.6.554"},{"key":"2025082803311024000_12.12.e231802.20","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1038\/nrrheum.2016.100","article-title":"Treatment of primary Sj\u00f6gren syndrome","volume":"12","author":"Saraux","year":"2016","journal-title":"Nat Rev Rheumatol"},{"key":"2025082803311024000_12.12.e231802.21","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.rdc.2016.03.010","article-title":"New treatment guidelines for Sj\u00f6gren's disease","volume":"42","author":"Vivino","year":"2016","journal-title":"Rheum Dis Clin North Am"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-231802","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:31:19Z","timestamp":1756377079000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-231802"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12]]},"references-count":21,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2019,12,29]]},"published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1136\/bcr-2019-231802"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-231802","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12]]}}}