RESUMO
The objective of the study was to search for clinical, ophthalmological and serological manifestations of Sjögren's syndrome in patients with adult onset Still's Disease (AOSD). Eight consecutive patients with AOSD were evaluated. In all cases a standardized questionnaire to disclose sicca symptoms as well as extraglandular manifestations commonly associated with Sjögren's syndrome(SS) was conducted. Ophthalmological and serological evaluation was undertaken in all patients. Oral involvement was investigated by minor salivary gland biopsy in 7 patients. One case presented symptomatic keratoconjunctivitis sicca and grade III Chisholm labial biopsy. A further 2 patients had grade IV (4 foci per 4 mm2) salivary gland biopsy, in the absence of xerostomia or xerophthalmia. The search for autoantibodies proved negative throughout. It was concluded that focal sialoadenitis was not uncommon in our patients with AOSD. Whether this finding corresponds to a true SS is not yet clearly determined.
Assuntos
Síndrome de Sjogren/complicações , Doença de Still de Início Tardio/complicações , Adulto , Anticorpos Antinucleares/metabolismo , Biópsia , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Ceratoconjuntivite Seca/complicações , Ceratoconjuntivite Seca/diagnóstico , Ceratoconjuntivite Seca/metabolismo , Masculino , Pessoa de Meia-Idade , Fator Reumatoide/metabolismo , Glândulas Salivares Menores/patologia , Testes Sorológicos , Sialadenite/complicações , Sialadenite/diagnóstico , Sialadenite/metabolismo , Síndrome de Sjogren/diagnóstico , Síndrome de Sjogren/metabolismo , Doença de Still de Início Tardio/diagnóstico , Doença de Still de Início Tardio/metabolismo , Inquéritos e QuestionáriosRESUMO
Fifteen patients with adult onset Still's disease are described, all diagnosed according to recognized criteria. Mean delay in reaching a firm diagnosis was 16 months. Besides the typical clinical picture, there was a high frequency of pruriginous rash, one instance of overlapping polymyositis and recurrent systemic manifestations in most cases. Chronic polyarticular involvement predominated, with radiological progression particularly in wrist, proximal interphalangeal and hip joints. However, functional prognosis at the end of a mean 4.8-year course was satisfactory, as also the response to treatment mainly with steroid drugs and, on occasion, with remitting agents to alleviate arthritis.