Compromiso pulmonar en síndrome de Sjõgren: caso clínico: [revisión] / Pulmonary involvement in primary Sjõgren's syndrome: a case report: [review]

Se presenta el caso de una mujer de 53 años con historia de aumento de volumen y dolor articular, pérdida de peso y síntomas sicca. El estudio de laboratorio mostró VHS elevada, anemia, linfopenia, hipocomplementemia y autoanticuerpos contra SSA/Ro y SSB/La, compatibles con un síndrome de Sjõgren (SS). Además, la radiografía de tórax mostró múltiples nódulos pulmonares, lo que fue confirmado por una TAC de tórax. El estudio histológico de los nódulos, plasmocitosis y proliferación linfocitaria atípica no demostró linfoma. Es ampliamente conocido que el SS confiere un mayor riesgo de desarrollar sindromes linfoproliferativos, lo que aumenta cuando hay presencia de vasculitis, hipo-complementemia y linfopenia. En este caso clínico el diagnóstico diferencial de la etiología de los nódulos pulmonares fue particularmente difícil. Dado lo anterior, se discute y revisa la literatura disponible acerca de compromiso pulmonar en SS.

We report the case of a 53-year old woman with a history of joint swelling and pain, weight loss and sicca symptoms. The laboratory showed a high ESR, anemia, lymphopenia, low complements and circulating auto-antibodies against SSA/Ro and SSB/La consistent with Sjõgren´s Syndrome (SS). Interestingly, the chest x-ray revealed multiple nodules in both lungs, which were corroborated by CT scan. The histological study of the pulmonary nodules showed plasmocytosis and atypical lymphocytes, but failed to demonstrate lymphoma. It is widely acknowledged that SS confers a high risk of developing lymphoproliferative syndromes, which is increased when vasculitis, low complements and lymphopenia are present. In this case, it was particularly difficult to elucidate the differential diagnosis of lung nodules. Accordingly, we discuss and review the available literature regarding pulmonary involvement in SS.

Estudio de la eficacia del condroitín 4 y 6 sulfato en los síntomas de la artrosis de rodilla / Study of the effectiveness of condroitín 4 and 6 sulphate in the symptoms of the artrosis of knee

We developed a prospective, open study to evaluate the efficacy of chondroitin sulfate in the treatment of kneeosteoarthritis. Methodology: We studied 61 patients with primary knee osteoarthritis. They were given 800mg/day chondroitin 4-and 6- sulfate (Condrosulf, IBSA, Switzerland) for a period of three months. Patients were controlled every 30 days using the Lequesne index and the visual analogue pain scale. Medication was suspended after 90 days and patients were reevaluated 90 days later. Only Paracetamol was allowed as analgesic. Results: After 90 days a significant improvement of45 percent was observed in the Lequesne index, and 59 percent for knee pain. Once medication is suspended, the effect tends to slowly revert, with final study results significantly better than basal levels. Residual effect is better in patients under age 65 and in those with less basal radiological damage. Subjective opinion of both patient and doctor concurs with results. Conclusions: Chondroitin 4-and 6- sulfate is effective for the symptomatic treatment of knee osteoarthritis. Its effect lasts several months after drug suspension.