Different cerebral functional segregation in Sjogren’s syndrome with or without systemic lupus erythematosus revealed by amplitude of low-frequency fluctuation

2021 ◽  
pp. 028418512110324
Author(s):  
Xiao-Dong Zhang ◽  
Jun Ke ◽  
Jing-Li Li ◽  
Yun-Yan Su ◽  
Jia-Min Zhou ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Low Frequency ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Frequency Fluctuation ◽  
Parahippocampal Gyrus ◽  
Systemic Lupus ◽  
The Right ◽  
Left Insula

Background Sjögren’s syndrome (SjS) associated with systemic lupus erythematosus (SjS-SLE) was considered a standalone but often-overlooked entity. Purpose To assess altered spontaneous brain activity in SjS-SLE and SjS using amplitude of low-frequency fluctuation (ALFF). Material and Methods Sixteen patients with SjS-SLE, 17 patients with SjS, and 17 matched controls underwent neuropsychological tests and subsequent resting-state functional magnetic resonance imaging (fMRI) examinations. The ALFF value was calculated based on blood oxygen level dependent (BOLD) fMRI. Statistical parametric mapping was utilized to analyze between-group differences and multiple comparison was corrected with Analysis of Functional NeuroImages 3dClustSim. Then, the ALFFs of brain regions with significant differences among the three groups were correlated to corresponding clinical and neuropsychological variables by Pearson correlation. Results ALFF differences in the bilateral precuneus/posterior cingulate cortex (PCC), right parahippocampal gyrus/caudate/insula, and left insula were found among the three groups. Both SjS-SLE and SjS displayed decreased ALFF in the right parahippocampal gyrus, right insula, and left insula than HC. Moreover, SjS-SLE showed wider decreased ALFF in the bilateral precuneus and right caudate, while the SjS group exhibited increased ALFF in the bilateral PCC. Additionally, patients with SjS-SLE exhibited lower ALFF values in the bilateral PCC and precuneus than SjS. Moreover, ALFF values in the right parahippocampal gyrus and PCC were negatively correlated to fatigue score and disease duration, respectively, in SjS-SLE. Conclusion SjS-SLE and SjS exhibited common and different alteration of cerebral functional segregation revealed by AlFF analysis. This result appeared to indicate that SjS-SLE might be different from SjS with a neuroimaging standpoint.

scholarly journals Pseudoaneurysm With A Fistula To The Right Ventricle Late After Surgical Repair of Type A Aortic Dissection in A Patient with Systemic Lupus Erythematosus: A Case Report

2021 ◽  
Author(s):  
Akie Shimada ◽  
Taira Yamamoto ◽  
Daisuke Endo ◽  
Kousuke Nishida ◽  
Satoshi Matsushita ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Aortic Dissection ◽  
Right Ventricle ◽  
Lupus Erythematosus ◽  
Type A ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Systemic Lupus ◽  
Type A Aortic Dissection ◽  
The Right

Abstract Background: Pseudoaneurysm with a shunt to the right ventricle after aortic repair for acute aortic dissection is an extremely rare and life-threatening condition. Surgical treatment is unavoidable, but surgery is complicated, and there are some pitfalls. Herein, we explain the reoperation procedure performed for a patient at high surgical risk by clarifying the shunt site using multi-modality imaging before surgery.Case presentation: A 69-year-old woman with a history of systemic lupus erythematosus (SLE) and Sjogren’s syndrome presented with a pseudoaneurysm 1 year after emergency surgery for acute type A aortic dissection. Eight years after the first operation, she experienced sudden chest pain and presented to the emergency department. Her dyspnea also worsened; therefore, echocardiography and three-dimensional computed tomography (3DCT) were performed, which revealed a pseudoaneurysm and a shunt to the right ventricle. The medical team attempted to close the shunt with a percutaneous catheter but was unsuccessful, and she was referred to our department for surgical treatment.The pseudoaneurysm originating from the proximal side of the aorta was large with a diameter of 55 mm, and echocardiography-gated 3DCT visualized the shunt from the pseudoaneurysm to the right ventricle. First, extracorporeal circulation was initiated, and a re-sternotomy was performed. We could not insert the left ventricular venting tube from the right side because of the size of the pseudoaneurysm; instead, the tube was inserted from the left atrial appendage. We found a half-circumferential disengaged anastomosis around the proximal anastomosis, which formed the large pseudoaneurysm leading to a fistula in the right ventricle. We closed the fistula and performed a Bentall operation.The patient had a good postoperative course and was discharged on postoperative day 21. She continued treatment for SLE and Sjogren’s syndrome and her inflammatory reaction improved.Conclusion: We performed a Bentall operation and closure of a fistula with a re-sternotomy in a patient with type A aortic dissection with systemic lupus erythematosus and Sjogren’s syndrome. Multimodal imaging is essential in defining the pseudoaneurysm and the fistula surrounding the anatomy while ensuring their resolution and guiding the approach for operation.

scholarly journals Doença Intersticial Pulmonar Grave e Mania Induzida por Corticosteróides em Doente com Lúpus Eritematoso Sistémico e Síndrome de Sjögren Secundária

2017 ◽  
Vol 30 (3) ◽  
pp. 246 ◽  
Author(s):  
Sofia Silvério Serra ◽  
Teresa Pedrosa ◽  
Sandra Falcão ◽  
Jaime Cunha Branco
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Sjögren’S Syndrome ◽  
Lupus Erythematosus ◽  
Sjögren's Syndrome ◽  
Manic Episode ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Neurological Involvement ◽  
Systemic Lupus ◽  
Sjögren‘S Syndrome

Interstitial lung disease occurs in up to 25% of patients with Sjögren’s syndrome and 2% - 8 % of patients with systemic lupus erythematosus. Corticosteroid therapy remains the main treatment for systemic lupus erythematosus. However, it can be associated with several neuropsychiatric disorders especially with prednisolone at a dose of more than 40 mg/day. We present the case of a 51-year-old patient with systemic lupus erythematosus and secondary Sjögren’s syndrome with severe pulmonary involvement four years after the diagnosis. Chest computed tomography revealed neofibrosis and ground glass appearance pattern. After increasing the dose of prednisolone to 60 mg/day, the patient presented a manic episode. There was need of hospitalization and the situation was considered to be secondary to corticosteroids at high doses. Central neurological involvement by organic disease was excluded.We introduced monthly perfusion of cyclophosphamide for six months and later started mycophenolate mofetil 2 g/day, reducing prednisolone to 10 mg/day and maintaining hydroxychloroquine 400 mg/day, with control of disease activity.

Sign in / Sign up

Export Citation Format

Share Document