Olho seco e Sjögren secundário na artrite reumatóide

Abstract

RESUMOObjetivo: Examinar a prevalência de ceratoconjuntivite seca e de Síndrome de Sjögren (SS) secundária em pacientes com AR do sul do Brasil e analisar suas relações com duração e atividade da AR e classe funcional do paciente. Pacientes com artrite reumatóide (AR) podem ter ceratoconjuntivite seca, que é considerada uma manifestação extra-articular dessa doença. Métodos: Estudaram-se 82 pacientes com AR para sintomas de secura, Schirmer teste, DAS-28 ( índice de atividade da AR) e classe funcional. Resultados: Sintomas de secura ocular estavam presentes em 57,3%, Schirmer positivo em 41,2% e SS secundária em 24.3%. A presença de um teste positivo para o Schirmer ou da SS secundária não teve associação com duração de doença (p=0,65 and 0,80), atividade da AR (p=0,42 and 0,25) nem com a classe funcional do paciente (p= 0.84 and 0,79). Conclusão: Existe uma alta prevalência de síndrome sicca nos pacientes com AR; ¼ deles tem SS secundário. O aparecimento de SS secundário e da síndrome sicca é independentes de atividade, tempo de duração e do dano cumulativo gerado pela AR subjacente .Descritores: Olho seco/etiologia; Síndrome de Sjögren/etiologia; Artrite reumatóide/complicações ABSTRACT Objective: To examine the prevalence of keratoconjuntivitis sicca and secondary Sjögren syndrome (SS) in patients with RA from Southern Brazil and to analyze their relationship with RA duration, activity and patient's functional class. Patients with rheumatoid arthritis (RA) may have keratoconjuntivitis sicca that can be considered an extra articular manifestation of this disease. Methods: We studied 82 RA patients for sicca symptoms, Schirmer test, DAS-28 (RA activity index) and functional class. Results: There were eye sicca symptoms in 57.3%, positive Schirmer test in 41.2% and Secondary SS in 24.3%. The presence of a positive Schirmer test or the secondary SS had no relation with disease duration (p=0.65 and 0.80), RA activity (p=0,42 and 0,25) and neither with the patient's functional class (p= 0.84 and 0.79). Conclusion: There is a high prevalence of sicca syndrome in RA patients; one fourth of them have secondary SS. Secondary SS and sicca syndrome occurrence is independent of underlying RA activity, duration and cumulative damage.

Are salivary flow rates associated with histopathologic aspects in patients with rheumatoid arthritis?

“…Secondary SS is commonly related to other autoimmune diseases and should be investigated in individuals with RA. 2,[11][12][13][14]31 Secondary SS has been reported to affect 22.2% of patients with RA. 16 Secondary SS was diagnosed in 31.8% of the patients in the present study, a rate that is higher than those reported in the literature.…”

“…This is in accordance with the epidemiological data on the disease and with the study carried out in Brazil in 2012, in which 87.8 of the participants were women and 20.5% met the sSS criteria. 14 Medication use has been associated with lower SFR, 10 leading to the assumption that the reduction of SFR in patients with RA can be a consequence of the great amount of medications used by these patients. Nevertheless, the influence of xerogenic medications on the SFR of these patients has been rarely studied.…”

“…11 Approximately 20% of individuals with RA present secondary Sjögren's syndrome (sSS), with a significant decrease in SFR. 2,[11][12][13][14] Early diagnosis and appropriate monitoring of SS associated with RA are important to improve the quality of life of these patients. 12,15 SS occurs as a primary form that is not associated with other diseases and as a secondary form that complicates other rheumatic conditions.…”

Transplante de glândulas salivares labiais no tratamento de olho seco em cães pela autoenxertia

“…The eye is one of the extra-articular structures affected by the condition, with keratoconjunctivitis sicca being the most common manifestation. Patients with RA and keratoconjunctivitis sicca may have a dry eye alone or as part of secondary Sjögren's syndrome, with progressive infiltration of exocrine glands by lymphocytes and plasma cells (3) . Another ophthalmic concern is related to blepharoplasty.…”