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Primary Sjögren Syndrome

Completed
Conditions
Primary Sjögren's Syndrome
Interventions
Other: skin biopsy
Registration Number
NCT01989819
Lead Sponsor
University Hospital, Limoges
Brief Summary

Primary Sjögren syndrome (pSS) is an inflammatory, autoimmune, multiorgan disease often involving the central and peripheral nervous systems. Fifteen to twenty percent of patients with the primary Sjögren's syndrome have neurological complications involving the peripheral nervous system. Although some patients have large fiber neuropathy, around forty percent of patients with Sjögren's syndrome experience neuropathic pain with normal electrodiagnostic studies. Although these patients may be diagnosed with fibromyalgia or depressive symptoms, some have been shown to have small fiber neuropathy (SFN). A recent study proved that more than 90% of pSS patients with such neuropathic pain have SFN {Fauchais, 2010 #188}.

The aim of this study will be to investigate the occurrence of small fiber neuropathy in patients with pSS and neuropathic pain with normal electromyographic studies and to determine the existence of a conjoint local inflammatory process mediated by cellular, cytokinic or auto-antibody response. Quantification of epidermal nerve fiber density after skin biopsy is a valuable tool to diagnose small fiber neuropathy and the method has been widely validated. A skin biopsy will be performed in patients and control and will allow quantification of small fiber density in skin sample along with measurement of sweat gland innervation. Moreover, pathophysiological studies will be carried on in order to evaluate the causal relationship between cellular and humoral inflammation and small fiberneuropathy.

Recent studies have pointed out the inconstant efficacy of both corticosteroid and immunosuppressive drugs in pSS-related SFN. Dissecting the molecular mechanisms of small fiber neuropathy in these patients may help designing new therapeutic strategies.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
44
Inclusion Criteria
  • Patients with pSS according to revised European criteria and exhibiting neuropathic pain without any electromyographic abnormality will be included (Group I).
  • Age of entry into the study ≥ 18 yrs (both groups).
  • Affiliated or profit patient of a social security system (both groups).
  • Informed consent signed up (both groups).
Exclusion Criteria
  • Chronic alcoholism
  • Type I or type II diabetes
  • Peripheral neuropathy unrelated to pSS complications
  • Coagulation disease
  • Previous allergy to xylocaine, lidocaine, prilocaine or ricin oil
  • Porphyria, methemoglobinemia
  • Patients under measure of maintenance of justice.
  • Patients unable to understand or to participate to the study.
  • Child and major patients making the object of a measure of lawful protection.
  • Patients deprived of freedom.
  • Pregnant, nursing women.
  • Participation in biomedical research within one month prior to inclusion.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
control groupskin biopsyA skin biopsy will be performed in control group
patients with Sjögren's syndromeskin biopsyA skin biopsy will be performed in patients
Primary Outcome Measures
NameTimeMethod
To evaluate the cutaneous lymphocytic infiltration1 year
Secondary Outcome Measures
NameTimeMethod
Cutaneous infiltration T, B and Th171 year

Trial Locations

Locations (7)

CH d'Albi

🇫🇷

Albi, France

CH de Brive

🇫🇷

Brive la Gaillarde, France

CHU Bordeaux

🇫🇷

Bordeaux, France

CHU Toulouse

🇫🇷

Toulouse, France

CHU de Lille

🇫🇷

Lille, France

University Hospital, Limoges

🇫🇷

Limoges, France

CH de Rodez

🇫🇷

Rodez, France

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