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KMID : 0882420090770020261
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Korean Journal of Medicine
2009 Volume.77 No. 2 p.261 ~ p.264
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A case of rheumatoid arthritis with Sjogren’s syndrome presenting as a tonic pupil
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Koh Jae-Ki
Kim Jin-Hyun
Ryu Hee-Jung
Lee Eun-Young
Lee Yoon-Jong
Lee Eun-Bong
Song Yeong-Wook
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Abstract
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Sjogren’s syndrome is an autoimmune disease that presents mainly as dry eyes and mouth, and occasionally with extra-glandular symptoms. A peripheral neuropathy is present in 10~30% of the cases with extra-glandular symptoms, although a tonic pupil caused by destruction of the ciliary ganglion is rare. We report a case of rheumatoid arthritis with Sjogren’s syndrome presenting as a tonic pupil. A 29-year-old woman was admitted for evaluation of polyarthralgia and a tonic pupil. On physical examination, she had polyarthritis involving the jaws, shoulders, wrists, and hands. Her pupils were anisocoric and did not react to light, but constricted promptly to pilocarpine. Biopsy of the minor salivary gland showed lymphocyte infiltration. Rose-Bengal stain was positive. She was diagnosed with rheumatoid arthritis with Sjogren’s syndrome and treated with prednisolone and hydroxychloroquine. Three months later, her polyarthritis had improved markedly, but she still had a tonic pupil.
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KEYWORD
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Sjogren’s syndrome, Rheumatoid arthritis, Tonic pupil
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