Sjögren’s Syndrome in Relation to Central Nervous System Disorders

(light music) Hi, everyone, my name is Erika Darrah. I’m here today with Dr. Julius Birnbaum from the Johns Hopkins Jerome L. Greene Sjogren Center to discuss his most recent research looking at the relationship between neurologic disorders and Sjogren’s Syndrome. First of all, I’d like to congratulate you, Dr. Brinbaum, on your exciting research, and thank you for joining us. Thank you. Can you start by describing the types of neurologic symptoms that patients with Sjogren’s Syndrome can experience? Sure, so a common neurological complication is a neuropathy where there can be severe burning in the fingertips and the toes. However, Sjogren’s patients can also experience neurological complication that is due to brain or spinal cord damage. This may affect thinking, or it can be more severe. It may result in blindness, paralysis, or even incontinence. So these types of neurological complications occur in a disorder called the Neuromyelitis optica spectrum disorder. Large name, it can be referred to by the acronym NMOSD. Multiple sclerosis, in effect, can cause similar neurological complications, but these tend to be less severe. So what was the major goal of your study? So, the goal of this study was to understand the relationship of NMOSD to Sjogren’s. There’s two possibilities. In one scenario, NMOSD would be a direct neurological complication due to Sjogren’s. And in that case, you would treat NMOSD with Sjogren’s Syndrome medications. However, another competing possibility is that NMOSD is totally unrelated to Sjogren’s. It presents as a second and coincidental disorder, and in this case, the treatments that you would use for Sjogren’s might not be sufficient for NMOSD. And what was your major conclusion of this study? So, our conclusion was that NMOSD was unrelated to Sjogren’s, and that patients who experience NMOSD have a second autoimmune disorder. And the therapeutic implication, as we discussed, is that if you are a Sjogren’s patient with NMOSD, you should be treated with NMOSD therapies that are wholly distinct from Sjogren’s Syndrome. So, is NMOSD and disorders like it, are they increased in patients with Sjogren’s Syndrome, compared to the general population? Yeah, it’s an interesting question. So, NMOSD is a very rare autoimmune disorder, and if you don’t have an autoimmune disease, it’s said that you have a better chance of being struck with lightning than experiencing NMOSD. That being said, when you have an autoimmune disease, such as Sjogren’s, you have a higher likelihood of experiencing NMOSD. So, it may be rare in Sjogren’s, but it’s disproportionately more common, compared to patients who don’t have Sjogren’s. Could you describe the connection between Sjogren’s Syndrome and other autoimmune diseases outside of NMOSD? Sure, so, Sjogren’s Syndrome patients definitely have a predilection to be affected by other autoimmune disorders. So, there’s an increased risk of autoimmune thyroid disease, there’s an increased risk of autoimmune liver disease or bile duct disease. So, each of these disorders are seen in Sjogren’s patients, and they have a predilection because Sjogren’s patients can produce antibodies that are seen in these disorders. So, in conclusion, can you describe the impact of this research on patients, what it means for patients with Sjogren’s Syndrome? I think there’s a variety of implications. So, first of all, for the patient who has NMOSD, this means if you have NMOSD, walk away from the treatment that’s being used in Sjogren’s. There’s a burgening supply of medications that are useful for NMOSD. This is where you should go. But you might be asking, “Well, what if I have Sjogren’s “and I don’t have NMOSD? “How is this gonna help me?” It’s another clue in the puzzle saying that here is yet another autoimmune disease that co-occurs in Sjogren’s. So, knowledge that these autoimmune diseases co-occur in Sjogren’s frames the question about why Sjogren’s are experienced with all of these extra neurological complications, other rheumatic diseases. If we understand why Sjogren’s patients can experience other autoimmune diseases, it starts setting the table of understanding diagnosis, identifying mechanisms, and also for tailoring more specific therapies. So what’s next for Sjogren’s Syndrome research? What are you working on now? So, our interest right now is galvanized by trying to understand why Sjogren’s Syndrome patients can experience severe nerve pain. It is a significant source of morbidity, it’s severe, it can be a factor in medications. And this is where we’re going right now, and this compliments our studies with brain and spinal cord disease. We really wanna understand why Sjogren’s patients develop neurological complications, and what we can do to alleviate their suffering. Great, so Dr. Birnbaum, thank you so much for your time. We look forward to see what you do next. Thanks for having me, thank you.

12 thoughts on “Sjögren’s Syndrome in Relation to Central Nervous System Disorders

  1. Thank you so much! This is very informative. As a Sjogrens patient, there is very little, if any, understanding from most of the Denver neurologists and rheumatologist I have seen about what Sjogrens has done and is doing to my body. I am not even currently on any Sjogrens meds, from my rheumatologist. This is frightening to me because of the amount of issues I have. Please let me know if you have any suggestions for the Denver area as to specialists in Sjögren's syndrome and related autoimmune diseases. We have no John Hopkins related facilities here.

  2. I already have multiple diagnosed autoimmune disorders. Since 11 minths of age in 1974 Juvenile onset Rheumatoid Arthritis, including chrinic extra-articular rheumatoid arthritis symptoms, 1974 Iridocyclitis, 1974 Iritis, 1976 Juvenile HPP (soft bones), 1989 Osteoarthritis,1985 SLE Lupus, 1978 Sjogrens Syndrome, 1980 POTS, 1993 Dysautonomia, and have experienced chronic symptoms of NMOSD since 1989. I am 43 years old.

  3. I feel myself getting weaker everyday. Why is it so hard for doctors to recognize my blood work doesn't lie. I have tried to get an appointment with him nut they said I couldn't because i already have a rhuematologist but she does nothing for me and I am getting sicker and sicker. What is the point of posting here if no one is going to respond to it?

  4. With sjogrens I have almost daily migraine, radial joint pain and constant fatigue. One day I feel and look great, next day 👎👎👎. Anyone else experience this?

  5. Sjogrens has gone from Syndrome to DISEASE in medical literature. We need to have a support group and conversations with THE specialist. Patients need care. Not Prozac.

  6. I’ve had a diagnosis of fibromyalgia, rheumatoid arthritis… Polyarthritis For years. I was hit by a car when I was 11. Had mononucleosis when I was 13. And I’ve recently been diagnosed with Sjogren’s, Addison’s, and thin persons Hashimoto’s. My blood work just came back compromised kidneys and liver. My brain fog is so bad I can’t even take care of myself much less all these diagnoses.

  7. I just read that NMOSD has an antibody they can test for. I'd love to know what that antibody is called. Can Dr. Birnbaum tell us?

  8. Dr. Julius Birnbaum specializes in both neurology and rheumatology and is a well of information for those of us who fall thru the autoimmune disease cracks of sub specialties. Wishing everyone well on their journey of accurate diagnosis and treatments <3

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