ABSTRACT
O propósito deste artigo é focar as principais manifestações neurológicas das doenças difusas do tecido conjuntivo, com ênfase nas suas manifestações clínicas. Os autores discutem as várias complicações do sistema nervoso central e periférico na doença muscular inflamatória (polimiosite e dermatomiosite), policondrite recidivante, esclerose sistêmica, artrite reumatoide, síndrome de Sjõgren, doença mista do tecido conjuntivo (doença de Sharp), lúpus eritematoso sistêmico e síndrome do anticorpo antifosfolipide.
The purpose of this article is to focus on the major nervous system manifestations in connective tissue diseases, with emphasis on their clinica findings. Authors discuss several complications in inflammatory muscle disease (polymyositis an dermatomyositis), relapsing polychondritis, systemic sclarosis, rheumatoid arthritis, Sjõgren syndorme, mixed connective tissue (Sharp disease), systemic lupus erythematosus and antiphospholipid syndrome.
Subject(s)
Male , Female , Connective Tissue Diseases/classification , Connective Tissue Diseases/complications , Connective Tissue Diseases/etiology , Connective Tissue Diseases/physiopathology , Connective Tissue Diseases/psychology , Arthritis, Rheumatoid/physiopathology , Mixed Connective Tissue Disease/physiopathology , Nervous System Diseases/classification , Nervous System Diseases/diagnosis , Nervous System Diseases/etiology , Nervous System Diseases/psychology , Scleroderma, Systemic/physiopathology , Lupus Erythematosus, Systemic/physiopathology , Polychondritis, Relapsing/physiopathology , Polymyositis/physiopathology , Antiphospholipid Syndrome/physiopathology , Sjogren's Syndrome/physiopathologyABSTRACT
Peripheral soft connective tissue lesions are common in oral mucosa and despite their benign nature can make problems for patients. According to our knowledge, a comprehensive study for these lesions was not performed in Iran General practitioners are commonly encountered affected with these lesions. They have not enough information about their clinical prevalence, may make mistake in diagnosis and treatment plan. The aim of this study was to evaluate peripheral soft connective tissue lesions prevalence in patients referred to Pathology department of Shahid Beheshti Dental School during 1981-2006. In this descriptive retrospective study [existing data], cases were patients that referred to Pathology Dept. [1981-2006] with complete files recorded in the Dept. Questionnaires included age, sex, location of lesion and lesion type which were retrieved from patient's files. The incomplete files were excluded. Finally the collected data were analyzed descriptively by SPSS Ver 11.0 software. A total number of 900 cases had peripheral soft connective tissue lesions during 1981-2006 from 4529 files in the department. 29.7% [268 cases] were irritation fibroma, 21.9% [197 cases] were peripheral giant cell granuloma, 19.5% [176 cases] were pyogenic granuloma, 19.3% [174 cases] were epulis fissuratum, 8% [72 cases] were peripheral ossifying fibroma, 0.5% [5 cases] were giant cell fibroma, 0.4% [4 cases] were oral focal mucinosis and 0.4% were inflammatory papillary hyperplasia. The most prevalent age was 50-59 years [18.1%] and 20-29 years [16.3%]. The lesions were more prevalent in women [61.9%] and were 38.1% in men. The most prevalent site was gingival [54.3%] and the least prevalent site was floor of the mouth [0.1%]. 19.9% peripheral soft connective tissue lesions were reported, the most frequent lesion was irritation fibroma that was similar to other reports
Subject(s)
Humans , Male , Female , Prevalence , Surveys and Questionnaires/statistics & numerical data , Retrospective Studies , Granuloma, Giant Cell/epidemiology , Granuloma, Pyogenic/epidemiology , Gingival Diseases/epidemiology , Connective Tissue Diseases/classification , Schools, Dental , Pathology Department, HospitalABSTRACT
El diagnóstico y clasificación de las enfermedades del tejido conjuntivo en los niños se ha basado principalmente en datos clínicos. Sin embargo, la adición de un número importante de hallazgos inmunológicos puede sustentar que en la infancia se presentan diferentes tipos y subgrupos de enfermedades autoinmunes. Los autoanticuerpos con diferentes especificidades definen no solo a distintos padecimientos sino también a diferentes subgrupos de pacientes con enfermedades del tejido conjuntivo. Esta revisión enfatiza que el factor reumatoide y los anticuerpos antinucleares son pruebas útiles que pueden ayudar a definir las características clínicas en niños con padecimientos reumáticos. El factor reumatoide de la clase IgM está presente frecuentemente en el grupo de pacientes con artritis reumatoide poliarticular, mientras que el grupo oligoarticular con uveitis tiene por características presentar una alta prevalencia de anticuerpos antinucleares. Los anticuerpos anti-DNA y anti-Sm son positivos en niños con lupus eritematoso generalizado. Los pacientes con dermatomiositis infantil tienen una menor frecuencia de anticuerpos contra los antígenos Jo-1 y PM-1, al compararlos con el grupo de polidermatomiositis del adulto. Los niños con esclerosis sistémica y síndome de CREST pueden mostrar anticuerpos anti-Scl-70 (topoisomerasa-1) y anticuerpos anti-centrómeto. Los títulos elevados de los anticuerpos anti RNpn (U1) parecen definir no sólo a la enfermedad mixta del tejido conjuntivo del adulto sino también a los niños. Los anticuerpos anti-SS-A (Ro) y anti-SS-B (La) han sido encontrados en pacientes con síndrome de Sjögren primario. Interesante otras anomalías, incluyendo a los anticuerpos antifosfolípidos, anti-proteínas hsp-70 y hsp-90, así como los anticuerpos contra productos contra oncogene-c-myc que han sido reportados en pacientes adultos con diferentes padecimietos del tejido conjuntivo, no han sido estudiados completamente en las enfermedades autoinmunes del niño. En suma los autoanticuerpos constituyen marcadores importantes que pueden ayudar a comprender lo complejo de la autoinmunidad en los niños.
Subject(s)
Antibodies/analysis , Connective Tissue Diseases/classification , Connective Tissue/immunology , Antibodies/classification , Antibodies/immunology , Connective Tissue Diseases/immunology , Connective Tissue/pathologyABSTRACT
La capilaroscopia in vivo del pliegue ungueal proximal de los dedos de las manos es un procedimento simple, no invasivo, con una sensibilidad y especificidad notables que lo convierten en una ayuda muy util en la valoracion de pacientes con enfermedades del tejido concetivo. Fueron examinados 65 pacientes con esclerosis sistemica progresiva, lupus eritematoso sistemico, dermattomiositis, fenomeno de Raynaud primario o artritis reumatoide. Los resultados confirman la ocurrencia de patrones caracteristicos de algunas entidades: el patron SD fue encontrado en todos los casos de dermatomiositis en 93% de esclerosis y en 80% de fenomeno de Raynaud primario. En la artritis reumatoide no existe un patron particular bien definido por lo que quizas la capilaroscopia es menos util. El seguimiento capilaroscopico de los pacientes con fenomeno de Raynaud primario puede predecir el desarrollo ulterior de una enfermedad sistemica del tejido concetivo.