Sjogern's versus multiple sclerosis

Hi guys. Just wondered if anyone here had any thoughts on sjogerns versus multiple sclersosis? I have read recently that two are quite similar and my aunt has MS. I was thinking that it could be possible that I could actually have MS and not sjogerns? Or both? I have literally just seen a rheumatologist who actually didn’t just suggest that my extremely high inflammation markers were as a result of me being overweight, given that I have lost 35 kilos over the last year and the symptoms are as bad as ever. I am hoping he might have some insight.

Anything’s possible, and there’s a pretty big overlap in terms of symptoms. Not a scientific paper, but interesting reading -

Another interesting paper showing the issue differentiating between the two -■■■■-1000175.php?aid=62724

The point? It can be hard to distinguish when there’s neurological involvement. Have you had a full panel for autoimmune disorders including SSA and SSB? Lip biopsy? Tear test? These can help point towards Sjogren’s.

My blood work is negative but my tear test showed reduced production. I am hoping to avoid the lip biopsy

I’m sero negative but have avoided the lip biopsy. I’ve also avoided the nerve biopsy to definitively diagnose small fiber neuropathy. In either case, the information gained wouldn’t change my management so they’re unnecessary.

Actually, yes it would change your management.

With a confirmed diagnosis, you could begin immunomodulatory therapy with a mab (Rituxan or Orencia), or with a JAK/STAT inhibitor (Xeljanz/Filgotinib).

I have definitely benefited from these.

For me it would not change my management. I have more than one autoimmune disease so I am being treated with a biologic already.

But yes, for somebody who is not already being treated for autoimmune disease it would definitely make a difference in how they are managed so it would be very worthwhile. I actually had this conversation with my neurologist who is very aware of autoimmune disorders. We decided at this point in time the biopsy was not worth it.

As soon as I started getting neuropathy symptoms, my rheumatologist sent me to a neurologist, who then immediately ordered an MRI of the brain. They said that because the symptoms of the 2 can be confused easily, they wanted to rule out MS. (No lesions on the brain so i am good there).

Very smart! It’s nice when they’re proactive like that.

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