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Sjögren Syndrome Associated Limbic Encephalitis and Its Longitudinal Brain FDG PET Manifestations
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DOI：10.1097/RLU.0000000000006226.png)
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Abstract
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A 62-year-old woman with Sj & ouml;gren syndrome, rheumatoid arthritis, and autoimmune hepatitis presented with subacute confusion and generalized seizures. MRI revealed bilateral mesial temporal T2/FLAIR hyperintensity. Serology revealed anti-SSA and anti-SSB antibodies elevated at 5 times above the upper limit of normal. FDG-PET demonstrated marked relative mesial temporal hypermetabolism with widespread hypometabolism in the rest of the brain; z-score mapping confirmed focal mesial temporal hyperactivity. They received immunotherapy and antiseizure therapy. After 1 year, cognition improved, though memory deficits persisted. Follow-up FDG-PET showed a transition from mesial temporal hypermetabolism to relative hypometabolism, with recovery of cortical metabolism, highlighting FDG-PET's role in diagnosing and monitoring autoimmune limbic encephalitis in Sj & ouml;gren syndrome.
Keywords:
Sj & ouml
gren syndrome
limbic encephalitis
FDG
PET
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