American Board of Internal Medicine (ABIM) Certification Practice Exam

Which of the following is often involved in the extraglandular manifestations of Sjögren syndrome?

1. High blood pressure

2. Pulmonary fibrosis

3. Neuropathy

4. Arthralgia

The correct answer is: Neuropathy

The involvement of neuropathy in the extraglandular manifestations of Sjögren syndrome is significant because this autoimmune disorder primarily affects exocrine glands, leading to dryness in the mouth and eyes. However, it can also present with systemic symptoms due to immune system dysregulation. Neuropathy in Sjögren syndrome can manifest as peripheral neuropathy, characterized by numbness, tingling, or pain in the extremities, and may occur as a direct consequence of the autoimmune process. The inflammation associated with Sjögren syndrome can affect nerve tissues, leading to various types of neuropathy, including sensory or motor neuropathies. The presence of neuropathy can often be indicative of serious underlying disease and serves as a potential marker for the severity of the condition. While other options may seem relevant, they have different prevalence or associations within the context of Sjögren syndrome. High blood pressure may be found in patients but is not specifically related to the autoimmune process itself. Pulmonary fibrosis occurs in various conditions, but it is less commonly associated with Sjögren syndrome. Arthralgia or joint pain is indeed a common symptom, but neuropathy demonstrates a more direct involvement in the complex pathophysiology of Sjögren syndrome's extrag