Autoantibodies binding to stathmin-4: new marker
for polyneuropathy in primary Sjögren’s syndrome
Reinhold E. Schmidt
Niklas T. Baerlecken
Published online: 14 November 2017
Springer Science+Business Media, LLC, part of Springer Nature 2017
Primary Sjögren’s syndrome (pSS) is an autoimmune disease
affecting exocrine glands  and may be associated with dif-
ferent extraglandular manifestations such as arthritis, myosi-
tis, vasculitis, and peripheral polyneuropathy (PNP) or central
nervous system affection .
A precise diagnosis of associated neurological manifesta-
tions is still a challenging endeavor. 8.5–67% of patients with
pSS complain about neurological symptoms. In approximate-
ly 9% of the patients, a polyneuropathy is diagnosed [3–5].
Interestingly, in 47% of patients with pSS, polyneuropathy
occurs before dryness of their mouth or eyes .
Most pSS patients develop a sensory axonal polyneuropathy.
The diagnostic procedures include physical examination, cere-
brospinal fluid, nerve conduction studies, electromyographies,
and sometimes nerve biopsy and skin biopsy [7, 8].
Up to now, there is no specific serological marker for
polyneuropathy in patients with pSS.
Therefore, we tried to screen for potential autoantibodies in
patients with pSS and polyneuropathy.
Patients, materials, and methods
We collected sera of patients with pSS (n =72),withsecond-
ary Sjögren’ssyndrome(sSS,n =20),SLE(n =36),rheuma-
toid arthritis (RA, n = 62), granulomatosis with polyangiitis
(GPA, n = 21), undifferentiated connective tissue disease
(UCTD, n = 27), multiple sclerosis (MS, n = 37), metabolic
and toxic PNP (n = 47), multiple myeloma (n = 44), and of
blood donors (BD, n = 128). The study was approved by the
ethical committee of the Medical School Hannover (project
number 4928), and the patients provided informed consent.
Research was carried out on humans in compliance with the
The patients with pSS fulfilled both the American-
European consensus group criteria and the ACR criteria of
2012. RA was classified according to the ACR/EULAR
criteria 2010, SLE according to the ACR criteria 1997, GPA/
eGPA according to Jennette et al., multiple myeloma accord-
ing to the criteria of the 2009 International Myeloma Working
Group, and multiple sclerosis according to the 2010 revision
of the McDonald criteria [9–16].
Demographic and laboratory data were obtained in the
Department of Clinical Immunology and Rheumatology and
in the Department of Neurology in the Medical School
Clinical and laboratory data were collected including age,
gender, c-reactive protein (CRP), erythrocyte sedimentation
rate (ESR), anti-Ro/SS-A, anti-La/SS-B, IgA anti-α-Fodrin,
rheumatoid factor (RF), complement factor C3c, complement
factor C4, Saxon test, Schirmer test, Chisholm und Mason
grade of glandolabial biopsy, subjective oral/ocular dryness,
* Niklas T. Baerlecken
Department of Clinical Immunology and Rheumatology, Hannover
Medical School, Hannover, Germany
Department of Neurology, Hannover Medical School,
Private Practice, Rheumatology, Schönsteinstr. 63,
Immunol Res (2017) 65:1099–1102