Li CY, Li YM, Tian M. Serum-negative Sjogren's syndrome with minimal lesion nephropathy as the initial presentation: A case report. World J Clin Cases 2022; 10(14): 4625-4631 [PMID: 35663069 DOI: 10.12998/wjcc.v10.i14.4625]
Corresponding Author of This Article
Mei Tian, PhD, Chief Doctor, Doctor, Department of Rheumatology, Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Road, Huichuan District, Zunyi 563003, Guizhou Province, China. 348820517@qq.com
Research Domain of This Article
Rheumatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 16, 2022; 10(14): 4625-4631 Published online May 16, 2022. doi: 10.12998/wjcc.v10.i14.4625
Serum-negative Sjogren's syndrome with minimal lesion nephropathy as the initial presentation: A case report
Chun-Yan Li, Yi-Man Li, Mei Tian
Chun-Yan Li, Mei Tian, Department of Rheumatology, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
Yi-Man Li, Department of Nephrology, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
Author contributions: Li CY and Li YM wrote the manuscript; all authors have given final approval to the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this case report in accordance with institutional guidelines.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mei Tian, PhD, Chief Doctor, Doctor, Department of Rheumatology, Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Road, Huichuan District, Zunyi 563003, Guizhou Province, China. 348820517@qq.com
Received: October 25, 2021 Peer-review started: October 25, 2021 First decision: December 17, 2021 Revised: December 24, 2021 Accepted: March 15, 2022 Article in press: March 15, 2022 Published online: May 16, 2022
Abstract
BACKGROUND
Primary Sjogren's syndrome (pSS) is an autoimmune disease, and renal involvement has been considered to be one of the systemic complications of pSS. Patients who have sjogren's syndrome with renal disease as the first manifestation and no exocrine gland involvement or autoantibodies can be missed clinically.
CASE SUMMARY
We here in report an unusual case of a primary Sjogren's syndrome in a 43-year-old female who had minimal lesion nephropathy as the initial presentation, and the patient was negative for serum anti-SSA and anti-SSB antibodies and did not have signs of exocrine gland involvement. The patient’s Sjogren's syndrome was confirmed by a minor salivary gland biopsy (MSGB) and a filter paper test. the patient’s oedema subsided, and the patient’s urinary protein resolved, showing that the treatment was effective.
CONCLUSION
MSGB should be considered if pSS is suspected in patients who do not have the typical pSS symptoms or who are positive for the specific autoantibodies.
Core Tip: Cases of serum-negative Sjogren's syndrome, when the patient has no symptoms of exocrine gland involvement and no hyperglobulinemia, where kidney disease is the first manifestation, and when minimal lesion nephropathy is seen in renal pathology, are rare. Therefore, minor salivary gland biopsy (MSGB) should be considered if pSS is suspected in patients who do not have the typical pSS symptoms or specific autoantibodies. MSGS has a primary value in the diagnosis of these patients.
