A case of rheumatoid arthritis with Sjogren's syndrome presenting as a tonic pupil.
- Author:
Jae Ki KOH
1
;
Jinhyun KIM
;
Hee Jeong RYU
;
Eun Young LEE
;
Yoon Jong LEE
;
Eun Bong LEE
;
Yeong Wook SONG
Author Information
1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. ysong@snu.ac.kr
- Publication Type:Case Report
- Keywords:
Sjogren's syndrome;
Rheumatoid arthritis;
Tonic pupil
- MeSH:
Adult;
Arthralgia;
Arthritis;
Arthritis, Rheumatoid;
Autoimmune Diseases;
Biopsy;
Eye;
Female;
Ganglion Cysts;
Hand;
Humans;
Hydroxychloroquine;
Jaw;
Light;
Lymphocytes;
Mouth;
Peripheral Nervous System Diseases;
Physical Examination;
Pilocarpine;
Prednisolone;
Pupil;
Salivary Glands, Minor;
Shoulder;
Sjogren's Syndrome;
Tonic Pupil;
Wrist
- From:Korean Journal of Medicine
2009;77(2):261-264
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Sjogren's syndrome is an autoimmune disease that presents mainly as dry eyes and mouth, and occasionally with extra-glandular symptoms. A peripheral neuropathy is present in 10~30% of the cases with extra-glandular symptoms, although a tonic pupil caused by destruction of the ciliary ganglion is rare. We report a case of rheumatoid arthritis with Sjogren's syndrome presenting as a tonic pupil. A 29-year-old woman was admitted for evaluation of polyarthralgia and a tonic pupil. On physical examination, she had polyarthritis involving the jaws, shoulders, wrists, and hands. Her pupils were anisocoric and did not react to light, but constricted promptly to pilocarpine. Biopsy of the minor salivary gland showed lymphocyte infiltration. Rose-Bengal stain was positive. She was diagnosed with rheumatoid arthritis with Sjogren's syndrome and treated with prednisolone and hydroxychloroquine. Three months later, her polyarthritis had improved markedly, but she still had a tonic pupil.