Sjögren’s syndrome complicated by ischemic stroke in the right middle cerebral artery territory – A case report

Abstract

Sjögren's syndrome (SS) is a chronic autoimmune condition characterized by lymphoplasmacytic infiltration into salivary and lacrimal glands, leading to sicca syndrome and systemic symptoms. While pulmonary, musculoskeletal, dermatological, and renal manifestations are well-documented, reports of central nervous system (CNS) involvement, particularly stroke, remain rare. We present a case report of a 30-year-old female whose initial manifestation of vasculitis associated with Sjögren's syndrome was an ischemic stroke. Laboratory findings revealed a positive ANA profile and radiological investigations showed an infarct in the right middle cerebral artery (MCA). The patient was then managed using steroids, antiplatelets, hydroxychloroquine, and physiotherapy. Although small-vessel vasculitis is commonly implicated in CNS involvement, major cerebral vessel involvement in Sjögren's syndrome is infrequently reported, with only three cases documented in the literature. This case highlights the importance of recognizing stroke as a potential manifestation of Sjögren-related vasculitis and expands the understanding of CNS complications in this autoimmune disorder. Increased awareness of this rare presentation may aid in prompt diagnosis and appropriate management of vasculitic complications in Sjögren's syndrome patients. Further research is needed to elucidate the underlying mechanisms and explore optimal treatment strategies for this subset of patients.