{
  "abstract": "Sjögren’s Disease (SjD) involves diverse extraglandular manifestations (EGMs). Severe hypergammaglobulinemia and suspected recurrent laryngeal nerve (RLN) -related unilateral vocal fold immobility represent aggressive phenotypes. Management of such presentations may be constrained by metabolic comorbidities such as diabetes, which limit the use of conventional high-dose glucocorticoids. Herein, we describe a 48-year-old female with SjD and Type 2 Diabetes Mellitus (T2DM) who presented with severe hypergammaglobulinemia (IgG 38.9 g/L), acute hoarseness, and sicca symptoms. Laryngostroboscopy demonstrated left-sided unilateral vocal fold immobility, possibly suggestive of neurogenic paralysis. Positron emission tomography-computed tomography (PET-CT) did not identify obvious masses or extrinsic compression along the visualized RLN course, reducing the likelihood of a compressive or malignant etiology. The EULAR Sjögren’s Syndrome Disease Activity Index (ESSDAI) score was 26. A combined therapeutic regimen comprising telitacicept (160 mg/week), methylprednisolone (20 mg/day) and hydroxychloroquine (0.2 g, twice daily) was initiated, both to minimize glucocorticoid exposure and to target the patient’s profound B-cell hyperactivity manifested by severe hypergammaglobulinemia. Marked serological and symptomatic improvements were observed during treatment. Within 15 weeks, the IgG level decreased to 14.6 g/L, rheumatoid factor (RF) decreased from 759 IU/mL to 58.3 IU/mL, and the ESSDAI score dropped to 6. The patient experienced symptomatic improvement of hoarseness, while methylprednisolone was successfully tapered to 4 mg/day. Clinical stability based on patient-reported symptoms persisted through the 12-month follow-up. This case is hypothesis-generating: A telitacicept-containing regimen may produce marked serological improvement and symptomatic benefit for high-activity SjD with laryngeal/vocal fold involvement, while reducing glucocorticoid-related metabolic risks. Definitive efficacy requires confirmation in larger controlled studies.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Rheumatology and Immunology, Shantou Central Hospital",
    "Department of Radiology, Shantou Central Hospital"
  ],
  "article_type": "research support, non u.s. gov't",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Kedi Zheng"
    },
    {
      "affs": [
        0
      ],
      "name": "Zexuan Zhou"
    },
    {
      "affs": [
        1
      ],
      "name": "Guangzhou Du"
    },
    {
      "affs": [
        0
      ],
      "name": "Qisheng Lin"
    },
    {
      "affs": [
        0
      ],
      "name": "Jianqun Lin"
    },
    {
      "affs": [
        0
      ],
      "name": "Weijin Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Shaoyu Zheng"
    },
    {
      "affs": [
        0
      ],
      "name": "Shijian Hu"
    },
    {
      "affs": [
        0
      ],
      "name": "Yukai Wang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3f5k47q3d0ykz.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1956268",
  "fulltext_url": "https://europepmc.org/articles/PMC13713689",
  "id": "3f5k47q3d0ykz",
  "issns": [
    "1664-3224"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1956268/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
    [
      "openalex",
      "2737|Salivary Gland Disorders and Functions"
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  "openalex": "W7221755658",
  "pdf_url": "https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1956268/pdf",
  "pmcid": "PMC13713689",
  "pmid": "42952743",
  "published": "2026-10-14",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/3f5k47q3d0ykz.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:17Z",
      "native_id": "10.3389/fimmu.2026.1956268",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1956268/full"
    },
    {
      "first_seen": "2026-10-31T00:20:41Z",
      "native_id": "MED:42952743",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42952743"
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    {
      "first_seen": "2026-10-31T12:24:11Z",
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2737|Salivary Gland Disorders and Functions",
      "subfield": "physiology"
    }
  ],
  "title": "Telitacicept for the treatment of Sjögren’s disease complicated by unilateral vocal fold immobility, severe hypergammaglobulinemia, and diabetes: a case report",
  "title_text": "Telitacicept for the treatment of Sjögren’s disease complicated by unilateral vocal fold immobility, severe hypergammaglobulinemia, and diabetes: a case report",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:21:19Z",
  "url": "https://research.draconitic.com/paper/3f5k47q3d0ykz",
  "venue": "Frontiers in Immunology",
  "versions": []
}