{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T08:15:34Z","timestamp":1759133734772,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,11,29]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:p>Primary Sjogren\u2019s syndrome (pSS) is an autoimmune connective tissue disorder with multisystem manifestations. We here report a previously healthy woman who presented with autonomic dysfunction in the form of severe dizziness without any apparent sensory neuropathy. Detailed history and examination revealed the signs and symptoms of Sjogren\u2019s syndrome such as constipation and dry eyes and mouth, following which anti-SSA and SSB antibodies were found to be positive. Finally, a diagnosis of pSS was established after ruling out all the other causes of autonomic dysfunction in addition to the clinical and laboratory evidence. The patient was treated with the maximum doses of midodrine and fludrocortisone, yet no progress was noticed. Hence, a trial of steroids was started and she showed a significant clinical improvement. Our patient presented with pure autonomic failure associated with Sjogren\u2019s syndrome, making it an extremely rare entity.<\/jats:p>","DOI":"10.1136\/bcr-2023-256412","type":"journal-article","created":{"date-parts":[[2023,12,9]],"date-time":"2023-12-09T13:10:13Z","timestamp":1702127413000},"page":"e256412","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Primary Sjogren\u2019s syndrome presenting as an isolated severe autonomic dysfunction treated with steroids"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2590-3962","authenticated-orcid":false,"given":"Riya","family":"Kataria","sequence":"first","affiliation":[{"name":"Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lakshmanan","family":"Suja","sequence":"additional","affiliation":[{"name":"General Medicine, Sri Ramachandra University Medical College, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Archa Anna","family":"Anil","sequence":"additional","affiliation":[{"name":"General Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Narayanasamy","family":"Senthil","sequence":"additional","affiliation":[{"name":"General Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, 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