[A case of progressive systemic sclerosis and Sjögren's syndrome complicated by parkinsonism with special reference to the beneficial effect of corticosteroid].
[A case of progressive systemic sclerosis and Sjögren's syndrome complicated by parkinsonism with special reference to the beneficial effect of corticosteroid].
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Original abstract
A 79-year-old woman was consulted by us because of 2 years' history of difficulty in neck flexion and frozen gait. On admission, the neurological examination disclosed findings compatible with parkinsonism such as bradykinesia and muscle rigidity. In addition, she felt thirsty and hard skin, cyanosis and Raynaud phenomenon in the limbs. These were consistent with diagnosis of progressive systemic sclerosis and Sjögren's syndrome, which was then confirmed by high titers of anti-nuclear antibody and anti-ENA antibody and abnormal sialogram; marked decrease of saliva and tear secretion was demonstrated. Brain CT and angiography showed no evidence of ischemic stroke. Parkinson symptoms were not relieved by a month's treatment with L-dopa, but was improved by 3 weeks' administration of corticosteroids; the latter also provided a benefit to the poor circulation in her finger tips. Parkinsonism in the present case is likely related to Sjögren's syndrome. Our report proposes a possibility of autoimmune disease as one of underlying causes for drug-resistant parkinsonism.