{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T17:35:31Z","timestamp":1789320931734,"version":"build-2803163510"},"reference-count":27,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2020,3,1]],"date-time":"2020-03-01T00:00:00Z","timestamp":1583020800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Background.<\/jats:bold>\n                    Sjogren\u2019s syndrome (SS) is among the most frequent autoimmune diseases and one of its most severe extraglandular manifestations is peripheral neuropathy. There is no consensus about peripheral neuropathy treatment in SS. Our aim is to identify studies proving the efficiency of immunosuppressive treatment on peripheral neuropathies in SS.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods.<\/jats:bold>\n                    The search was conducted on the PubMed (MEDLINE) database. Studies with patients diagnosed with SS and peripheral neuropathy were included. Treatment with one of the following was among inclusion criteria: glucocorticoids (GC), rituximab (RTX), azathioprine (AZA), mycophenolic acid (MMF), cyclophosphamide (CP), methotrexate (MTX), plasmapheresis or iv immunoglobulins (IV IG).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results.<\/jats:bold>\n                    A total of 116 results were found and abstracts were examined. 103 papers were excluded, and the remaining 13 papers were analyzed. They were 3 case series and 10 case reports, retrospective, totalizing 62 patients of which 22 (35.5%) received IV IG, 8 (13%) received RTX, 7 (11%) CP, and 5 (8%) received only GC. Drug associations containing corticosteroids were frequent. Of those 22 treated with IV IG, 18 patients improved (82%), and 4 stabilized (18%).\n                  <\/jats:p>\n                  <jats:p>IV IG was useful in sensory, motor and sensorimotor neuropathies. CP had good results in mononeuritis multiplex, while autonomic neuropathies responded well to GC or RTX. AZA, RTX, MTX, MMF or plasmapheresis were not used alone. Follow-up periods were heterogenous and the evaluation of the neuropathy was not systematic.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion.<\/jats:bold>\n                    There is only low level evidence (retrospective case reports and case series). In most cases, IV IG treatment in patients with peripheral neuropathies and SS resulted in clinical improvement, while other therapies, such as RTX, corticosteroids and CP proved to be useful in a handful of cases.\n                  <\/jats:p>","DOI":"10.2478\/rjim-2019-0022","type":"journal-article","created":{"date-parts":[[2019,9,17]],"date-time":"2019-09-17T05:05:06Z","timestamp":1568696706000},"page":"5-12","source":"Crossref","is-referenced-by-count":11,"title":["Immunosuppressive treatment for peripheral neuropathies in Sjogren\u2019s syndrome \u2013 a systematic review"],"prefix":"10.2478","volume":"58","author":[{"given":"Andreea Camelia","family":"Hum\u0103","sequence":"first","affiliation":[{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy , Faculty of Medicine , Bucharest , Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyn Maria","family":"Kecske\u015f","sequence":"additional","affiliation":[{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy , Faculty of Medicine , Bucharest , Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delia","family":"Tulb\u0103","sequence":"additional","affiliation":[{"name":"Neurology Department , Colentina Clinical Hospital , Bucharest , Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"B\u0103l\u0103nescu","sequence":"additional","affiliation":[{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy , Faculty of Medicine , Bucharest , Romania"},{"name":"Internal Medicine Department , Colentina Clinical Hospital , Bucharest , Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"B\u0103icu\u015f","sequence":"additional","affiliation":[{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy , Faculty of Medicine , Bucharest , Romania"},{"name":"Internal Medicine Department , Colentina Clinical Hospital , Bucharest , Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2020,3,3]]},"reference":[{"key":"2026042914161886041_j_rjim-2019-0022_ref_001_w2aab3b8b8b1b7b1ab1ab1Aa","doi-asserted-by":"crossref","unstructured":"1. 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J Neurol Sci. 2009; 279:57\u201361.10.1016\/j.jns.2008.12.01819168191","DOI":"10.1016\/j.jns.2008.12.018"},{"key":"2026042914161886041_j_rjim-2019-0022_ref_008_w2aab3b8b8b1b7b1ab1ab8Aa","doi-asserted-by":"crossref","unstructured":"8. LEVY Y., UZIEL Y., ZANDMAN G.G., AMITAL H., SHERER Y., LANGEVITZ P. et al. Intravenous immunoglobulins in peripheral neuropathy associated with vasculitis. Ann Rheum Dis. 2003; 62:1221\u20133.10.1136\/ard.2002.003996175438514644864","DOI":"10.1136\/ard.2002.003996"},{"key":"2026042914161886041_j_rjim-2019-0022_ref_009_w2aab3b8b8b1b7b1ab1ab9Aa","doi-asserted-by":"crossref","unstructured":"9. MOCHIZUKI H., KAMAKURA K., MASAKI T., HIRATA A., NAKAMURA R., MOTOYOSHI K. Motor dominant neuropathy in Sjoegren\u2019s syndrome: Report of two cases. Intern Med. 2008; 41:142\u20136.10.2169\/internalmedicine.41.14211868603","DOI":"10.2169\/internalmedicine.41.142"},{"key":"2026042914161886041_j_rjim-2019-0022_ref_010_w2aab3b8b8b1b7b1ab1ac10Aa","unstructured":"10. 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Korean J Intern Med. 2000; 15:89\u201392.10.3904\/kjim.2000.15.1.89453175110714099","DOI":"10.3904\/kjim.2000.15.1.89"},{"key":"2026042914161886041_j_rjim-2019-0022_ref_015_w2aab3b8b8b1b7b1ab1ac15Aa","doi-asserted-by":"crossref","unstructured":"15. SHIMOYAMA M., OHTAHARA A., OKAMURA T., WATANABE M., FUJIMOTO Y., TESHIMA S. et al. Isolated autonomic cardiovascular neuropathy in a patient with primary Sj\u00f6gren syndrome: a case of successful treatment with glucocorticoid. Am J Med Sci. 2002; 324:170\u20132.10.1097\/00000441-200209000-0001012240717","DOI":"10.1097\/00000441-200209000-00010"},{"key":"2026042914161886041_j_rjim-2019-0022_ref_016_w2aab3b8b8b1b7b1ab1ac16Aa","unstructured":"16. DUPOND J.L., GIL H., DE WAZIERES B. Five-year efficacy of intravenous gammaglobulin to treat dysautonomia in Sj\u00f6gren\u2019s syndrome. Am J Med. 1999; 106:125."},{"key":"2026042914161886041_j_rjim-2019-0022_ref_017_w2aab3b8b8b1b7b1ab1ac17Aa","doi-asserted-by":"crossref","unstructured":"17. 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Intravenous immunoglobulin therapy in sensory neuropathy associated with Sj\u00f6gren\u2019s syndrome. J Neurol Neurosurg Psychiatry. 1996; 60:699.10.1136\/jnnp.60.6.69910739668648349","DOI":"10.1136\/jnnp.60.6.699"},{"key":"2026042914161886041_j_rjim-2019-0022_ref_020_w2aab3b8b8b1b7b1ab1ac20Aa","doi-asserted-by":"crossref","unstructured":"20. TAKAHASHI Y., TAKATA T., HOSHINO M., SAKURAI M., KANAZAWA I. Benefit of IVIG for long-standing ataxic sensory neuronopathy with Sj\u00f6gren\u2019s syndrome. IV immunoglobulin. Neurology. 2003; 60:503\u20135.10.1212\/01.WNL.0000046680.47883.7D","DOI":"10.1212\/01.WNL.0000046680.47883.7D"},{"key":"2026042914161886041_j_rjim-2019-0022_ref_021_w2aab3b8b8b1b7b1ab1ac21Aa","doi-asserted-by":"crossref","unstructured":"21. MORI K., IIJIMA M., KOIKE H., HATTORI N., TANAKA F., WATANABE H. et al. The wide spectrum of clinical manifestations in Sj\u00f6gren\u2019s syndrome-associated neuropathy. Brain. 2005; 128:2518\u201334.10.1093\/brain\/awh60516049042","DOI":"10.1093\/brain\/awh605"},{"key":"2026042914161886041_j_rjim-2019-0022_ref_022_w2aab3b8b8b1b7b1ab1ac22Aa","doi-asserted-by":"crossref","unstructured":"22. GORSON K.C., NATARAJAN N., ROPPER A.H., WEINSTEIN R. Rituximab treatment in patients with IVIg-dependent immune polyneuropathy: A prospective pilot trial. Muscle Nerve. 2007; 35:66\u20139.10.1002\/mus.2066416967492","DOI":"10.1002\/mus.20664"},{"key":"2026042914161886041_j_rjim-2019-0022_ref_023_w2aab3b8b8b1b7b1ab1ac23Aa","doi-asserted-by":"crossref","unstructured":"23. BOTEZ S.A., HERRMANN D.N. Prolonged remission of a demyelinating neuropathy in a patient with lymphoma and Sj\u00f6gren\u2019s syndrome after Rituximab therapy. J Clin Neuromuscul Dis. 2010; 11:127\u201331.10.1097\/CND.0b013e3181c5051320215986","DOI":"10.1097\/CND.0b013e3181c50513"},{"key":"2026042914161886041_j_rjim-2019-0022_ref_024_w2aab3b8b8b1b7b1ab1ac24Aa","doi-asserted-by":"crossref","unstructured":"24. MEIJER J.M., MEINERS P.M., VISSINK A., SPIJKERVET F.K.L., ABDULAHAD W., KAMMINGA N. et al. Effectiveness of rituximab treatment in primary Sj\u00f6gren\u2019s syndrome: A randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2010; 62:960\u20138.10.1002\/art.2731420131246","DOI":"10.1002\/art.27314"},{"key":"2026042914161886041_j_rjim-2019-0022_ref_025_w2aab3b8b8b1b7b1ab1ac25Aa","doi-asserted-by":"crossref","unstructured":"25. VOULGARELIS M., GIANNOULI S., TZIOUFAS A.G., MOUTSOPOULOS H.M. Long term remission of Sjogren\u2019s syndrome associated aggressive B cell non-Hodgkin\u2019s lymphomas following combined B cell depletion therapy and CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone). 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