Hao LJ, Zhang J, Naveed M, Chen KY, Xiao PX. Subclavian steal syndrome associated with Sjogren's syndrome: A case report. World J Clin Cases 2021; 9(27): 8171-8176 [PMID: 34621877 DOI: 10.12998/wjcc.v9.i27.8171]
Corresponding Author of This Article
Ping-Xi Xiao, PhD, Consultant Physician, Department of Cardiology, Sir Run Run Hospital, Nanjing Medical University, No. 109 Longmian Avenue, Jiangning District, Nanjing 210000, Jiangsu Province, China. sysu-xiao@163.com
Research Domain of This Article
Peripheral Vascular Disease
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. Sep 26, 2021; 9(27): 8171-8176 Published online Sep 26, 2021. doi: 10.12998/wjcc.v9.i27.8171
Subclavian steal syndrome associated with Sjogren's syndrome: A case report
Li-Jun Hao, Jing Zhang, Muhammad Naveed, Kai-Yan Chen, Ping-Xi Xiao
Li-Jun Hao, Ping-Xi Xiao, Department of Cardiology, Sir Run Run Hospital, Nanjing Medical University, Nanjing 211166, Jiangsu Province, China
Jing Zhang, Muhammad Naveed, Department of Clinical Pharmacology, Nanjing Medical University, Nanjing 211166, Jiangsu Province, China
Kai-Yan Chen, Department of Clinical Medicine, Nanjing Medical University, Nanjing 211166, Jiangsu Province, China
Author contributions: Hao LJ, Zhang J, and Naveed M contributed equally to this work; Hao LJ and Xiao PX contributed to the design of the study; Zhang J and Chen KY managed the article search and helped to draft the manuscript; Naveed M and Zhang J contributed to revising the manuscript; all authors have approved the final manuscript.
Supported byGeneral Funding of Health Commission of Jiangsu Province, No. H2019076.
Informed consent statement: The patient has provided informed consent for publication of the case.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ping-Xi Xiao, PhD, Consultant Physician, Department of Cardiology, Sir Run Run Hospital, Nanjing Medical University, No. 109 Longmian Avenue, Jiangning District, Nanjing 210000, Jiangsu Province, China. sysu-xiao@163.com
Received: April 9, 2021 Peer-review started: April 9, 2021 First decision: April 23, 2021 Revised: May 16, 2021 Accepted: August 13, 2021 Article in press: August 13, 2021 Published online: September 26, 2021
Abstract
BACKGROUND
Subclavian steal syndrome (SSS) caused by Sjogren's syndrome is rare, especially for elderly patients with risk factors for atherosclerosis. The current report presents the uncommon etiology and treatment of SSS, aiming to improve doctor’s clinical experience.
CASE SUMMARY
A 69-year-old man was diagnosed with hypertension and acute cerebral infarction presenting with left upper limb weakness and pain even gradually aggravating to left limb hemiplegia 30 years ago. He was managed with antihypertensive and antithrombotic therapy; however, his condition was recurrent, and he never had any further examination. It was found that the difference of the bilateral upper arm systolic pressure was over 20 mmHg, and Doppler examination showed that the blood flow of the left vertebral artery was reversed, suggesting SSS. Further tests revealed a benign lymphoepithelial lesion in salivary gland tissue, confirming the Sjogren's syndrome.
CONCLUSION
The patient was found to have hypertension when he was 33 years old, and the blood pressure of both sides was asymmetric, which was ignored. The patient's symptoms of dizziness and upper limb weakness were misdiagnosed as general cerebral infarction. It is necessary to test the aorta computed tomography angiography to prove secondary hypertension factors such as Sjogren's syndrome.
Core Tip: We present a case of subclavian steal syndrome caused by Sjogren's syndrome where the patient had experienced dizziness and left upper limb weakness for 10 years despite medical treatment and was misdiagnosed as general cerebral infarction. This case illustrates the significance of detailed history collection and physical examination. A young patient with hypertension needs to measure bilateral blood pressure and examine the immunologic condition and aorta computed tomography angiography to analyze secondary hypertension factors such as Sjogren's syndrome.
