# CSF Anti-Sjögren’s Syndrome Antigen A Antibodies and Low Glucose Levels in Sjögren’s Syndrome-Associated Aseptic Meningitis: A Case Report

## TL;DR

A rare case of aseptic meningitis linked to Sjögren’s syndrome is reported, with low CSF glucose and anti-SS-A antibodies as potential diagnostic clues.

## Contribution

This case report highlights reduced CSF glucose and positive CSF anti-SS-A antibodies as possible indicators of pSS-associated aseptic meningitis.

## Key findings

- CSF analysis showed pleocytosis, elevated protein, and decreased glucose levels.
- Both serum and CSF anti-SS-A antibodies were positive with an elevated antibody index.
- Steroid pulse therapy improved the patient’s condition.

## Abstract

Primary Sjögren’s syndrome (pSS) rarely involves the CNS, including cases of aseptic meningitis (AM). We report the case of a 59-year-old woman who presented with headache, fever, and nuchal rigidity. CSF analysis revealed pleocytosis, elevated protein, and decreased glucose levels. Both serum and CSF anti-Sjögren’s syndrome antigen A (anti-SS-A) antibody tests were positive, with an elevated CSF anti-SS-A antibody index. Salivary gland biopsy confirmed the diagnosis of pSS. The patient improved following steroid pulse therapy. Reduced CSF glucose levels in combination with positive CSF anti-SS-A antibody tests may serve as supportive clues for pSS-associated AM. Evaluation of autoimmune features and CSF anti-SS-A antibodies may aid in the diagnosis of AM of unclear etiology.