A 58-year-old woman came in with fever and headache. Her sodium levels were dangerously low - and despite correction, they weren’t improving. Something didn’t add up. Initial tests for meningitis, including MRI and CSF analysis, were inconclusive. But a deeper clinical history revealed persistent joint pains. Could this be autoimmune? A PET-CT scan showed abnormal brain hypermetabolism, and further autoimmune testing confirmed Sjögren’s syndrome presenting as immune-mediated meningoencephalitis.
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