ABSTRACT
Abstract Background: Primary Sjögren syndrome (pSS) is a chronic autoimmune disease with its main target being exocrine glands, and is the connective tissue disease more frequently associated with other autoimmune diseases. The aim of this study was to assess the frequency of another autoimmune rheumatic disease (ARD) developed in primary Sjögren syndrome (pSS) patients and to describe it's clinical, serological and histologic characteristics. Materials and methods: This is a retrospective cohort study. Data of patients with pSS diagnosis (American-European criteria 2002), included in the GESSAR database (Grupo de Estudio Síndrome de Sjögren, Sociedad Argentina de Reumatología) were analyzed. The development of a second ARD was registered during the follow up. Results: 681 patients were included, 94.8% female. The mean age was 54 (SD 14) years and mean age at diagnosis of 50 (SD 13) years. The mean follow-up was 4.7 (SD 4.9) years; 30 patients (4.41%, CI 95%: 3.1-5.7) developed a second ARD during the follow up, incidence rate was 9.1/1000 patients-year (IR 95%: 5.8-12.4/1000 patients-year), the most frequent being rheumatoid arthritis (RA). 96% out of these 30 patients had xerophthalmia, 86.2% xerostomia, 92% positive Schirmer test, 88.24% positive Rosa Bengala test, lisamine green or Ocular Staining Score, 81.2% positive unstimulated salivary flow, 82.1% Ro(+) and 33.33% La(+). Minor salivary gland biopsy had been performed in 14 of the 30 patients, 12 with positive results. There were no statistically significant differences respect baseline characteristics when comparing the patients who developed another ARD to the ones that did not. Conclusions: Of all the patients analyzed, 4.4% presented another ARD during their follow-up. It is important to be aware of this, to make an early and proper diagnosis and treatment of our patients. Key points Patients with primary Sjögren's Syndrome may develop another connective tissue disease during follow-up. The most frequently connective tissue disease developed during follow-up in the population of patients with primary Sjogren's Syndrome studied was rheumatoid arthritis. It is important to be aware of this to make an early and proper diagnosis.
ABSTRACT
Se realizó un estudio de corte transversal, descriptivo simple, observacional, correlacional, estudiando osteoporosis y factores de riesgo asociados en 31 personas, 16 varones y 15 mujeres mayores de 50 años que viven en una población rural de montaña, en la pampa de Achala, Povincia de Córdoba, República Argentina. Se realizó cuestionario para detectar factores de riesgo para osteoporosis, examen físico, laboratorio de metabolismo fosfocálcico, radiografías de columna dorsal y lumbar y densitometría ósea de columna lumbar y caderas. Considerando las dos regiones estudiadas 66% de la muestra tuvo baja densidad mineral ósea. 19% tuvo osteoporosis en columna lumbar y 19% en caderas, 29% osteopenia en columna lumbar y 25% en caderas. Si consideramos población femenina, el 33% tuvo osteoporosis y el 33% osteopenia en columna lumbar, mientras que el 26% tuvo osteoporosis y el 20% osteopenia en cadera. En cuanto a la población masculina, el 6% tuvo osteoporosis y el 25% osteopenia en columna lumbar, y el 12,5% 12,5% osteoporosis y 31% osteopenia en caderas. 10 personas, que equivale al 32% de la muestra, tuvieron fracturas vertebrales radiológicas, de las cuales el 40% fueron asintomáticas. Los factores de riesgo que demostraron asociación significativa fueron por test de chi cuadrado fueron antecedentes familiares (p<0.05), la hipocalcemia (p<0.05) y hubo una tendencia que no alcanzó significación estadística con la vitamina D (p<0.07), por coeficiente de Spearman fueron el índice de masa corporal en mujeres, el antecedente personal de fractura, en ambas regiones, ambos sexos, el consumo de calcio por día en columna en varones, las horas de caminata en ambos sexos y la vitamina D con mejores resultados en trocanter en mujeres.