Hepatitis C Virus Induced Sjogren Syndrome - Clinical and Imaging Features

Abstract

Currently incurable, Charcot-Marie-Tooth (CMT) disease is the most commonly inherited neurological disorder, which affects a small percentage of the population. The most common cause of CMT is the duplication of a region on the short arm of chromosome 17, which includes the gene PMP22. We report a thirty-seven-year-old man with CMT disease having sleep, memory and attention disorders characterized by brief retrograde amnesia at early age. The patient has no genetic disease in the family, but was diagnosed with diabetes mellitus, which emphasizes the sensory loss and prolonged infections. Diabetes mellitus emphasizes the sensory symptomatology and predisposes to the development of infections with delayed healing.

Keywords: Charcot-Marie-Tooth; inherited neuromuscular disorder; sleep disorders.

Figure 1

Intense brownish pigmentation on lower limb of Patient A suggestive of palpable purpura in the setting of cryoglobulinemicvasculitis

Figure 2

Parotid gland US features of patient A. B-mode US image shows severe PIH, marked by multiple well-defined anechoic areas, of over 6 mm in diameter, which corresponds to PIH score of 4

Figure 3

Imaging features in patient B. Head and neck CT scan: (a) native CT scan in transverse plane shows both parotid glands (arrows) increased in size and displaying structural changes with a cystic-like pattern; (b-c) sialotomography images after administration of contrast agent in which both right (b) and left (c) parotid glands display dilated canalicular ducts. Parotid gland US exam: (e) B-Mode US longitudinal scan image displays severe PIH, with large anechoic areas, some measuring over 1 cm (arrowhead), frequently confluent, multiple cysts and calcifications (arrows), severely modified glandular architecture; (f) Power Doppler US image which shows increased vascularity pattern