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Background: Dehydroepiandrosterone (DHEA) is an adrenal hormone used to treat rheumatic conditions such as systemic lupus erythematosus (SLE), Sjogren's syndrome (SS), rheumatoid arthritis (RA) with controversial results. Aim: To review the results of DHEA use in rheumatic diseases. Methods: PubMed, Scielo, Scopus, and Embase databases were systematically searched for articles on the treatment of rheumatic diseases with DHEA between 1966 and April 2023. Results: Twenty-one studies were identified: 13 in SLE, 5 in SS, 2 in RA, and 1 in fibromyalgia. DHEA use in SLE has shown a mild to moderate effect on disease activity, a positive effect on bone mineral density (BMD), and improved fatigue. The studies on SS showed a decrease in symptoms of dry mouth, but its performance did not differ from placebo in disease activity. In RA, a questionable effect on disease activity was noted. The only study on fibromyalgia failed to show any improvement. The drug was well tolerated; mild androgenic effects were the most common complaints. Conclusion: DHEA seems to have a place in SLE treatment, where it improves BMD and disease activity. The use in RA, SS, and FM is questionable.
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Introdução: As espondiloartrites são doenças musculoesqueléticas crônicas que podem ter envolvimento axial, periférico ou misto. Devido ao grande comprometimento físico esta doença causa importante redução da qualidade de vida, mas não se sabe se isto acontece de igual maneira nas 3 formas. Objetivo: Estudar a associação entre qualidade de vida e formas de espondiloartrites. Método: Coletaram-se dados acerca de epidemiologia, perfil clínico, comorbidades e de qualidade de vida (através do SF-12 ou Short Form Health Survey12 questions). Resultados: Incluíram-se 120 indivíduos: 60 EpA e 60 controles. O SF-12 físico tinha mediana de 38,05 para espondiloartrites e 55,1 para controle (p<0,0001). No quesito mental as medianas foram de 42,1 e 50,1 com p=0,04. Não foi possível demonstrar diferenças nos subgrupos de espondiloartrites, tanto no aspecto físico como mental (p=0,33 e 0,30 respectivamente). Conclusão: Existem diferenças significativas na qualidade de vida entre espondiloartrites e controles, mas não entre os subgrupos das espondiloartrites.
Introduction: Spondyloarthritis are chronic musculoskeletal diseases divided as axial, peripherical and mixed diseases. Due to a great physical involvement, it reduces patients' quality of life, but it is unknown how the 3 forms of the disease behave in such context. Objective: To study the quality of life association with spondyloarthritis forms. Methods: Data collection included: epidemiologic data, clinical profile, and quality of life data evaluated through the SF-12 (Short Form Health Survey12 questions). Results: About 120 individuals were included: 60 spondyloarthritis and 60 controls. The physical SF-12 showed median of 38.05 for spondyloarthritis and 55.1 for controls (p<0.0001). The medians in mental SF-12 were 42.1 and 50.1 with p= 0.04. No differences in quality of life in the spondyloarthritis subgroups could be detected (with p=0.33 and 0.30 for physical and mental aspects). Conclusion: There was a significant difference in quality of life between spondyloarthritis sample and controls but not among the spondyloarthritis subgroups.
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Humanos , Reumatologia , EspondilartriteRESUMO
BACKGROUND: Patients with rheumatoid arthritis (RA) may have nutritional impairment. In RA, muscle loss is associated with an increase in fat tissue, and the patients may not have body mass index (BMI) alterations. AIM: To study the nutritional status in a sample of patients with RA in Brazil through mini nutritional assessment (MNA) and electric bioimpedance and its relationship to BMI, functionality, disease activity, and treatment. METHODS: Seventy-one RA females were included. Chart review was used to obtain epidemiological, clinical, and treatment data. Patients answered the MNA and were submitted to electrical bioimpedance and anthropometric measurements. Disease activity was assessed through simple disease activity index (SDAI), clinical disease activity index (CDAI), and function, through health assessment questionnaire (HAQ). RESULTS: According to MNA, 23 (32.4%) patients were at risk for malnutrition and 1 (1.4%) was malnourished. MNA were associated with disease activity and function impairment (SDAI P = .02; CDAI P = .02, and HAQ P = .002) but not with used medications. According to BMI, 76% were overweight or obese. An increased percentage of body fat was found in 98.7% and a lower percentage of lean mass in 95.7%. Disease activity and function were not associated with the percentage of body fat of any used medications, with a lower percentage of body fat in those using abatacept (P = .01). CONCLUSION: Almost one-third of patients had nutritional impairment according to MNA which was associated with disease activity and loss of function. Almost the whole sample had an increased percentage of fat mass and a diminished percentage of muscle mass that could not be linked with disease activity, function or used medications.
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Artrite Reumatoide , Desnutrição , Feminino , Humanos , Abatacepte , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/epidemiologia , Composição Corporal/fisiologia , Índice de Massa Corporal , Brasil/epidemiologia , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Avaliação Nutricional , Estado NutricionalRESUMO
Artrite reumatoide é doença reumática autoimune e crônica. Acredita-se que a obesidade pode intervir nos seus parâmetros inflamatórios. O objetivo deste estudo foi verificar se existe correlação entre atividade inflamatória dela e o índice de massa corporal (IMC).É estudo transversal retrospectivo nos quais foram obtidos dados de biometria (peso e altura) para cálculo do IMC e de atividade inflamatória. Estudaram-se 676 pacientes (87,5% mulheres com mediana de idade de 59,6 anos). Nesta população, 1,3% estava abaixo do peso normal; 28,1% dentro do peso normal; 35,3% sobrepeso; 31% obesidade grau I e 4,1% obesidade grau 2. Encontrou-se fraca correlação entre o DAS 28-PCR com o IMC. Correlações com os demais parâmetros de inflamação foram não significantes. Em conclusão existe alta proporção de pacientes com artrite reumatoide acima do peso normal e fraca correlação entre IMC e DAS28-PCR
Rheumatoid arthritis is an autoimmune and chronic rheumatic disease. It is believed that obesity can intervene in its inflammatory parameters. The objective of this study was to verify if there is a correlation between her inflammatory activity and the body mass index (BMI). It is a retrospective cross-sectional study in which biometric data (weight and height) were obtained to calculate BMI and inflammatory activity. We studied 676 patients (87.5% women with a median age of 59.6 years). In this population, 1.3% were underweight; 28.1% within normal weight; 35.3% overweight; 31% grade I obesity and 4.1% grade 2 obesity. We found a weak correlation between DAS 28-CRP and BMI. Correlations with the other inflammation parameters were not significant. In conclusion, there is a high proportion of patients with rheumatoid arthritis above normal weight and a weak correlation between BMI and DAS28-CRP
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Adulto , Artrite Reumatoide , Índice de Massa Corporal , Inflamação , Obesidade , Estudos Transversais , BiometriaRESUMO
BACKGROUND: Fibromyalgia (FM) patients are treated with antidepressants, and in most cases, these drugs lose efficacy or present side effects. Intravenous lidocaine (IL) is an anesthetic drug used in some FM trials. AIM: To systematically review the safety and efficacy of IL in FM patients. METHODS: To systematically search PubMed for articles in English, Spanish, and Japanese with English Abstracts on FM and lidocaine between 1966 and February 2021. This study was registered at PROSPERO. RESULTS: We found only ten articles published in this field, with a total of 461 patients. Females predominated varying from 95% to 100% in the studies. Age varied from 40.9 to 55 years old. Disease duration varied from 1 mo to 6.4 years. Lidocaine dose varied from 2 to 7.5 mg/kg via intravenous infusion. Follow-up period varied from 65.7 to 90 days. Regarding outcomes, most studies used the visual analogue scale (VAS) for pain; before short-term lidocaine administration, VAS was between 6.1 and 8.1 and after treatment was between 1.7 and 4.5 mm. Concerning long term lidocaine, VAS varied from 30% to 35.4% after lidocaine infusion. Side effects were observed in 0% to 39.6% of cases, they were usually mild or moderate. CONCLUSION: This study demonstrates the short-term effectiveness and safety of intravenous lidocaine in FM patients. However, more studies, including long-term follow-up, are still needed.
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Vaccination is a current strategy used to prevent infections in patients with immune-mediated rheumatic diseases. However, the use of live-attenuated vaccines prepared from living microorganisms in these patients should be avoided due to the risk of acquiring infections. The present study aimed to investigate the effect of the yellow fever (YF) vaccine (a live-attenuated vaccine) in 12 patients with rheumatoid arthritis (RA). The sample comprised 12 patients (9 females and 3 males; mean age 52.2 ± 6.5 years) with RA, who inadvertently received fractionated 17D yellow fever vaccination during an outbreak of this disease. In this cohort, 10 were administered leflunomide; 7 were administered methotrexate; 6 were administered prednisone (median dose of 5.0 mg/day); 6 took biologic drugs; and 1 took tofacitinib. All but one patient (used rituximab, prednisone, and methotrexate) seroconverted. None of them developed clinical signs of infection after the procedure. The fractionated dose of the YF vaccine is effective and safe in the observed sample. Key Points ⢠Patients with autoimmune inflammatory rheumatic diseases (AIIRD) are at a high risk of acquiring infections ⢠The fractionated dose of the YF vaccine is effective and safe in the observed sample ⢠Vaccination against YF should be avoided in patients with AIIRD under immunosuppression owing to the risks of inducing YF infection.
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Artrite Reumatoide , Febre Amarela , Anticorpos Neutralizantes , Anticorpos Antivirais , Artrite Reumatoide/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Soroconversão , Vacinação , Febre Amarela/prevenção & controleRESUMO
INTRODUCTION: Adverse childhood experiences (ACEs) have been linked to occurrence of autoimmune diseases in adults, including psoriasis. OBJECTIVES: To study the prevalence of ACEs in psoriasis patients, comparing them with a sample from the general population. METHODS: Three hundred and eighteen individuals were included (104 psoriasis patients and 214 controls). Patients and controls answered questions on an ACE study questionnaire about experiences of childhood abuse, negligence, domestic violence, and household dysfunction. Questionnaire scores range from zero (best result) to 8 (worst scenario). Psoriasis patients' charts were reviewed for epidemiological, clinical, and treatment data. A Psoriasis Area Severity Index (PASI) was calculated from measurements taken when the questionnaire was administered. RESULTS: Psoriasis patients reported a median of 4 ACEs (interquartile range [IQR] = 3-5) while controls had a median of 3 (IQR = 2-4) with p < 0.0001. The number of ACEs was not associated with PASI, age of disease onset, or presence of associated arthritis (all p > 0.5). Female psoriasis patients had more ACEs than males (p = 0.04). CONCLUSION: Patients with psoriasis have more ACEs than controls and ACEs were more common in female patients.
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Experiências Adversas da Infância , Maus-Tratos Infantis , Violência Doméstica , Psoríase , Adulto , Criança , Feminino , Humanos , Masculino , Psoríase/epidemiologia , Inquéritos e QuestionáriosRESUMO
Abstract Introduction Adverse childhood experiences (ACEs) have been linked to occurrence of autoimmune diseases in adults, including psoriasis. Objectives To study the prevalence of ACEs in psoriasis patients, comparing them with a sample from the general population. Methods Three hundred and eighteen individuals were included (104 psoriasis patients and 214 controls). Patients and controls answered questions on an ACE study questionnaire about experiences of childhood abuse, negligence, domestic violence, and household dysfunction. Questionnaire scores range from zero (best result) to 8 (worst scenario). Psoriasis patients' charts were reviewed for epidemiological, clinical, and treatment data. A Psoriasis Area Severity Index (PASI) was calculated from measurements taken when the questionnaire was administered. Results Psoriasis patients reported a median of 4 ACEs (interquartile range [IQR] = 3-5) while controls had a median of 3 (IQR = 2-4) with p < 0.0001. The number of ACEs was not associated with PASI, age of disease onset, or presence of associated arthritis (all p > 0.5). Female psoriasis patients had more ACEs than males (p = 0.04). Conclusion Patients with psoriasis have more ACEs than controls and ACEs were more common in female patients.
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BACKGROUND: Systemic lupus erythematosus (SLE) may have a different serological and clinical profile according to age of disease onset. AIM: To compare clinical presentation and serological data from patients with SLE onset in childhood (cSLE) with disease onset in adulthood (aSLE) in a sample of Brazilian patients. METHODS: Retrospective study of 614 SLE patients from a single Rheumatology Unit from Brazil: 77 (12.5%) cSLE and 537 (87.4%) aSLE. Clinical and serological data were obtained from the charts. Comparisons of cSLE with aSLE in general and according to patient's gender were made. RESULTS: The comparison of whole sample showed that children had more malar rash (p = 0.04), seizures (p < 0.0001), psychosis (p = 0.02), glomerulonephritis (p = 0.001), anti-dsDNA (p = 0.008), anticardiolipin IgM (p = 0.04) but less discoid lesions (p = 0.01), anti-Ro (p < 0.0001) and anti-La antibodies (p = 0.007). When only the male sample was compared, no differences in glomerulonephritis and anti-dsDNA frequencies were found. CONCLUSION: Children had a higher frequency of severe manifestations (glomerulonephritis and central nervous system) than adults. The difference in glomerulonephritis occurrence disappeared when only males were compared.
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Anticorpos Anticardiolipina/imunologia , Anticorpos Antinucleares/imunologia , Lúpus Eritematoso Sistêmico/imunologia , Lúpus Eritematoso Sistêmico/patologia , Adolescente , Adulto , Idade de Início , Brasil/epidemiologia , Estudos de Casos e Controles , Criança , Exantema/diagnóstico , Exantema/epidemiologia , Feminino , Glomerulonefrite/diagnóstico , Glomerulonefrite/epidemiologia , Humanos , Imunoglobulina M/imunologia , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/epidemiologia , Masculino , Prevalência , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/epidemiologia , Estudos Retrospectivos , Convulsões/diagnóstico , Convulsões/epidemiologia , Índice de Gravidade de DoençaRESUMO
BACKGROUND: Dry eyes are common in the general population. Some studies associate high prevalence of dry eyes with lipid metabolic changes and body fat composition. AIM: To study the association of dry eye with percentage of body fat. METHODS: One hundred and thirty five individuals (44 males and 91 females; median age of 42 years) were studied in a cross-sectional prospective study. Schirmer test and TBUT (tear breakup time) test were used to access dry eye. Body composition (percentage of lean and fat mass) were calculated using anthropometric measurements that included height, weight, abdominal, waist and neck circumference. RESULTS: About 44.4% of the sample had abnormal Schirmer test, and 70.3% had abnormal TBUT. Schirmer tests values were associated with age (p = 0.0006) female gender (p = 0.04) and percentage of body fat (p = 0.02). Abnormal TBUT test associated only with age (p = 0.0005). CONCLUSIONS: Percentage of body fat is associated with abnormal Schirmer but not TBUT test.
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Síndromes do Olho Seco , Tecido Adiposo , Adulto , Estudos Transversais , Síndromes do Olho Seco/diagnóstico , Síndromes do Olho Seco/epidemiologia , Feminino , Humanos , Masculino , Estudos Prospectivos , LágrimasRESUMO
Dry eyes may be caused by impairment in the tear production or excessive tear evaporation and are associated with photophobia, red eyes, vision impairment, local pain and pruritus. It has been described that patients with Diabetes Mellitus (DM) may have a higher prevalence of dry eyes than normal population. This is a case control study of 120 patients with Diabetes Mellitus (DM) and 120 paired controls aiming to compare their prevalence of dry eyes (by the Schirmer test) and its severity (measured by OSDI or Ocular Surface Disease Index) as well as their association with diseases' clinical variables. We found that 38.3% of DM patients had dry eyes, a prevalence that was higher than controls (p = 0.02). At univariate analysis, they were found to be more common in older individuals (p = 0.001) with type 2 diabetes (p = 0.001) and in those using metformin (p = 0.001). A multivariate linear regression showed that metformin use was the only independent variable associated with dry eyes. When patients with dry eyes with and without DM were compared, no differences in the symptom's intensity were found.
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Diabetes Mellitus Tipo 2 , Síndromes do Olho Seco , Idoso , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Síndromes do Olho Seco/diagnóstico , Síndromes do Olho Seco/epidemiologia , Humanos , Prevalência , LágrimasRESUMO
INTRODUCTION: Sleep quality may be impaired in systemic scleroderma (SSc) patients and contribute to loss of life quality. AIM: The aims of this study were to study the prevalence of sleep disturbance in SSc patients and its possible association with epidemiological, clinical and laboratory data, treatment used, and depression, and to verify the association of sleep disturbance and quality of life in this group of patients. METHODS: This is a cross-sectional study including 60 SSc patients. Epidemiological, clinical, laboratory, and treatment data were extracted from the medical records. To evaluate sleep quality, the PSQI (Pittsburgh Sleep Quality Index) was used; to evaluate depression, the CES-D (Center for Epidemiological Scale-Depression) was used; and to evaluate quality of life, SF-12 (12-Item Short-Form Health Survey) was used. Disease severity was evaluated by the Medsger index and the degree of cutaneous involvement by the modified Rodnan index. RESULTS: The prevalence of patients with sleep disturbance was 73.3%. Sleep disturbance was associated with esophageal involvement (p = 0.03), Medsger index with higher disease severity (p = 0.01), and more depressive mood (p = 0.002). Patients with poor quality of sleep had worse quality of life by the SF-12 in mental (p = 0.001) and physical domains (p = 0.0008). No associations were found with epidemiological, serological, and treatment variables (all P's = nonsignificant). CONCLUSIONS: There is a high prevalence of sleep disturbance in patients with SSc that is associated with esophageal involvement, severity of disease, depression, and worse quality of life.
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Qualidade de Vida , Transtornos do Sono-Vigília , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/etiologia , Humanos , Sono , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etiologia , Inquéritos e QuestionáriosRESUMO
OBJECTIVES/HYPOTHESIS: Antimalarial drugs (chloroquine and hydroxychloroquine) are widely used for the treatment of systemic lupus erythematosus (SLE). However, these drugs may have side effects such as hearing loss. This study aimed to describe the hearing function in SLE patients using antimalarials. Secondarily, this study aimed to investigate whether SLE causes hearing loss and if there are any serological or clinical aspects of this diseases associated with inner ear damage. STUDY DESIGN: Cross-sectional study. METHODS: This study included 84 individuals (43 SLE patients and 41 controls) with audiometry and tympanometry tests. Epidemiological, clinical, serological, and treatment profiles of SLE patients were extracted from the charts. RESULTS: SLE patients had more sensorineural hearing loss than controls (23.2% vs. 0; P = .001). Pure-tone averages in SLE patients using antimalarials and not using antimalarials were similar (8.75 vs. 8.75; P = .63). At 8,000 Hz, antimalarial dug nonusers performed worse than users (10.00 vs. 22.50; P = .03). Tympanometry was normal in all participants. SLE serological and clinical profiles in patients with and without hearing loss were the same (all P = nonsignificant). CONCLUSIONS: There is a high prevalence of hearing loss in SLE that is not affected by antimalarial drug use. LEVEL OF EVIDENCE: 3b Laryngoscope, 131:E957-E960, 2021.
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Antimaláricos/efeitos adversos , Cloroquina/efeitos adversos , Perda Auditiva Neurossensorial/epidemiologia , Hidroxicloroquina/efeitos adversos , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Testes de Impedância Acústica , Adulto , Audiometria de Tons Puros , Estudos Transversais , Feminino , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/etiologia , Humanos , Lúpus Eritematoso Sistêmico/complicações , Masculino , Pessoa de Meia-Idade , PrevalênciaRESUMO
O lúpus eritematoso sistêmico (LES) é doença autoimune crônica. Uma das suas importantes complicações é o dano cardiovascular. O objetivo deste trabalho foi estudar a prevalência de disfunção cardíaca em uma população local com LES e verificar se o grau de disfunção está associado com o a atividade da doença medida pelo SLEDAI (Systemic Lupus erythematosus activity index). Foram selecionados 19 pacientes assintomáticos do ponto de vista cardiovascular com diagnóstico de LES e que preenchiam os critérios classificatórios. A atividade de doença foi medida pelo SLEDAI e a função cardíaca por ecocardiografia transtorácica. Em conclusão, não foi possível identificar disfunção cardíaca na amostra estudada. Pontuações mais altas no índice de atividade do lúpus demonstraram correlação com aumento de massa de ventrículo esquerdo e fração de ejeção.
Systemic lupus erythesis (SLE) is a chronic autoimmune disease. One of the important complications of this disease is the cardiovascular damage The objective of this work was to study the prevalence of cardiac dysfunction in a local population with SLE and to verify whether the degree of dysfunction is associated with the disease activity measured by SLEDAI (Systemic Lupus erythematosus activity index). Were selected 19 patients asymptomatic from cardiovascular point of view diagnosed with SLE and who met the classification criteria for SLE. Disease activity was measured by SLEDAI and cardiac function was evaluated by transthoracic echocardiography. In conclusion, cardiac dysfunction could not be identified in the sample studied. Higher scores in the lupus activity index showed a correlation with increased left ventricle mass and ejection fraction.
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Antitopoisomerase-1 (ou Scl-70) é um autoanticorpo considerado como biomarcador da forma difusa de esclerodermia. Alguns autores o têm encontrado em pacientes com lúpus. O objetivo deste estudo foi estudar a presença do anticorpo Scl-70 em lúpus eritematoso sistêmico (SLE). É pesquisa com 94 pacientes com LES para anticorpo anti Scl-70 usando o kit comercial de ELISA Virgo™, Columbia, USA. Dados clínicos, epidemiológicos e sorológicos foram obtidos dos prontuários. Como resultado, somente 2 pacientes (2.1%) tinham anticorpos anti Scl-70 em baixos títulos. Nenhum deles tinha características de esclerodermia. Em conclusão, não se confirmam achados anteriores acerca da presença de anti Scl-70 em lúpus. Este anticorpo parece ser específico para esclerodermia.
Antitopoisomerase-1 (or Scl-70) is an autoantibody considered as a biomarker of the diffuse form of scleroderma. Some authors have found it in lupus patients. The aim of this study was to study the presence of the Scl-70 antibody in systemic lupus erythematosus (SLE). It is screened with 94 SLE patients for anti Scl-70 antibody using the commercial Virgo™ ELISA kit, Columbia, USA. Clinical, epidemiological and serological data were obtained from medical records. As a result, only 2 patients (2.1%) had anti-Scl-70 antibodies at low titers. None of them had features of scleroderma. In conclusion, previous findings regarding the presence of anti Scl-70 in lupus are not confirmed. This antibody appears to be specific for scleroderma.
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A esclerodermia (ES) é doença de tecido conjuntivo com preponderância feminina. Os hormônios sexuais parecem modular seusachados clínicos. O objetivo deste trabalho foi estudar a influência do início da doença antes ou depois da menopausa. Estudo retrospectivo de 74 mulheres com ES de uma única unidade de reumatologia para dados clínicos, sorológicos e epidemiológicos. A gravidade da doença foi medida pelo índice Medsger e o envolvimento da pele pelo índice de Rodman modificado. A comparação dos dados de doença de início na pré e pós-menopausa foi feita. Em conclusão, pacientes com ES com início da doença pré e pós-menopausa têm perfil clínico e sorológico semelhantes, exceto para úlceras digitais mais comuns nas pré-menopausais.
Scleroderma (SSc) is a connective tissue disease with female preponderance. Sex hormones appear to modulate their clinical findings. The objective of this work was to study the influence of the onset of the disease before or after menopause. Retrospective evaluation of 74 women with SSc from a single rheumatology unit for clinical, serological and epidemiological data. Disease severity was measured by the Medsger index and skin involvement by the modified Rodman index. Comparison of pre- and post-menopausal onset disease data was performed. In conclusion, patients with SSc with pre- and post-menopausal disease onset have similar clinical and serological profiles, except for digital ulcers that are more common in pre-menopausal women.
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A esclerose sistêmica (ES) é doença sistêmica crônica e autoimune. Estima-se que dor musculoesquelética esteja presente entre 40-80% dos pacientes, sobretudo naqueles com doença difusa precoce. O objetivo deste trabalho foi estudar a prevalência de manifestações musculoesqueléticas em ES, verificar se sua presença altera o perfil clínico, qual a prevalência de fator reumatoide na ES e sua associação com manifestações musculoesqueléticas. É estudo retrospectivo envolvendo 48 pacientes com ES. Foram coletados dados sobre epidemiologia, manifestações clínicas e exames laboratoriais Coletou-se também o valor do HAQ. Em conclusão, manifestações articulares da ES estão associadas com pior funcionalidade e a miosite aparece nos mais jovens. Um quarto dos pacientes é positivo para fator reumatoide, mas ele não se associa com as manifestações musculoesqueléticas.
Systemic sclerosis (SSc) is a chronic and autoimmune systemic disease. It is estimated that musculoskeletal pain is present in 40-80% of patients, especially those with early diffuse disease. The objective of this work was to study the prevalence of musculoskeletal manifestations in SSc, verify if its presence alters the clinical profile, the prevalence of rheumatoid factor in SSc and its association with musculoskeletal manifestations. It is a retrospective study involving 48 patients with SSc. Data on epidemiology, clinical manifestations and laboratory tests were collected. The HAQ value was also collected. In conclusion, joint manifestations of SSc are associated with worse functionality and myositis appears in the youngest. A quarter of patients are positive for rheumatoid factor but it is not associated with musculoskeletal manifestations.
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Lúpus eritematoso sistêmico (LES) é doença autoimune sistêmica que cursa com doença vascular. O objetivo deste estudo foi avaliar a diferença dos valores do índice tornozelo braquial (ITB) de pacientes com LES e da população geral, para identificação de doença aterosclerótica. É estudo transversal observacional, incluindo 150 indivíduos (75 portadores de LES e 75 controles). Análises epidemiológicas e medida do ITB foram feitas em ambos os grupos. Os prontuários de pacientes com LES foram revisados para perfil clínico, sorológico e de tratamento, indice de atividade da doença e dano cumulativo. Em conclusão, os pacientes com LES apresentam maior valores alterados de ITB quando comparados com a população geral. O perfil clínico, sorológico, de atividade e o dano cumulativo não se associaram com o ITB.
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that courses with vascular disease. The objective of this study was to evaluate the difference in the values of the ankle brachial index (ABI) of patients with SLE and the general population, for the identification of atherosclerotic disease. It is an observational cross-sectional study, including 150 individuals (75 SLE patients and 75 controls). Epidemiological analyzes and measurement of ABI were performed in both groups. The charts of SLE patients were reviewed for clinical, serological, and treatment profile, disease activity index, and cumulative damage. In conclusion, patients with SLE have higher altered ABI values when compared to the general population. Clinical, serological, activity profile and cumulative damage were not associated with ABI.
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A esclerodermia cursa com espessamento importante da pele, o qual pode afetar a mobilidade e função das mãos. O objetivo deste estudo foi avaliar o acometimento das mãos em pacientes com esclerodermia sistêmica. É estudo transversal de 43 pacientes com esclerodermia para dados clínicos e epidemiológicos, presença de STC (síndrome de túnel do carpo), força da mão medida pelo dinamômetro Jamar®, e função da mão pelos questionários de Hamis e Cochin. Estes pacientes foram comparados com 43 controles. Em conclusão, pacientes de esclerodermia têm pior função da mão do que controles. A presença de queixas musculoesqueléticas afeta destreza e força da mão, enquanto que a presença de STC influencia na presença de parestesias. O grau de envolvimento cutâneo e a forma da esclerodermia não modificaram a função da mão.
Scleroderma progresses with significant thickening of the skin, which can affect the mobility and function of the hands. The aim of this study was to evaluate the involvement of the hands in patients with systemic scleroderma. It is a cross-sectional study of 43 patients with scleroderma for clinical and epidemiological data, presence of CTS (carpal tunnel syndrome), hand strength measured by the Jamar® dynamometer, and hand function by the Hamis and Cochin questionnaires. These patients were compared with 43 controls. In conclusion, scleroderma patients have worse hand function than controls. The presence of musculoskeletal complaints affects dexterity and hand strength, while the presence of CTS influences the presence of paresthesias. The degree of skin involvement and the form of scleroderma did not change hand function.