ABSTRACT
Changes in nailfold capillaroscopy in systemic sclerosis patients could be related to the disease severity. The aim of this study was to investigate whether patients with "late" scleroderma (SD) pattern have more organ involvement than patients with "early/active" SD pattern. Forty-six Argentinian patients (44 women and 2 men), with a diagnosis of systemic sclerosis, were distributed in two groups based on the presence of late and early/active patterns. Organ involvement was assessed as follows: pulmonary function by chest radiography, high-resolution chest tomography (HRCT), lung volume tests, and diffusing capacity for carbon monoxide (DLCO); esophageal involvement by manometry; and pulmonary arterial hypertension (PAH) by Doppler echocardiography and six-minute walk test. Honeycombing of the lungs evaluated by HRCT was more frequently present in patients with late pattern compared with early/active patients (p = 0.01). We also found statistically significant differences in lung volume tests (p = 0.03) and DLCO (p = 0.02) between the two SD pattern groups. Esophageal manometry showed a significantly higher frequency of motility disorders in the group with late pattern (p = 0.0024). In this study, patients with late pattern had higher frequency of pulmonary and esophageal involvement compared with patients with early/active pattern.
Subject(s)
Microscopic Angioscopy/methods , Scleroderma, Systemic/diagnosis , Scleroderma, Systemic/physiopathology , Aged , Argentina , Disease Progression , Female , Humans , Male , Middle Aged , Nails/pathology , Tomography, X-Ray Computed/methodsABSTRACT
El hallazgo de anticuerpos específicos y datos histopatológicos son indispensables para llegar al diagnóstico de síndrome de Sjögren (SS). La biopsia de glándulas salivales menores (BGSM), si bien es un procedimiento sencillo, debe ser realizada en una institución a fin de evitar complicaciones. Objetivo: Estimar la frecuencia de complicaciones mediatas e inmediatas y el rédito de la técnica. Materiales y métodos: Se incluyeron los pacientes derivados al Hospital Rivadavia para realización de biopsia, entre octubre del 2007 y mayo del 2010. Los pacientes fueron citados a la semana y al mes del procedimiento para control de la lesión. Resultados: Frecuencia de complicaciones inmediatas (n = 186): 15 pacientes: 8,1%, IC del 95%, 4,7-13,2 (sangrado 7,5%, lipotimia 3,2%, hematomas 2,7%; no hubo accidentes). Complicaciones mediatas (n = 164): 16 pacientes: 9,75%, IC del 95%, 5,9-15,6 (dolor 7,32%, signos inflamatorios 3,66%, trastornos de sensibilidad 3,05%, granuloma 1,22%). No hubo casos de infecciones, ni dehiscencia del punto de sutura. Rédito microscópico: total 154 biopsias: se obtuvo tejido glandular en el 90,9%, IC del 95%, 85-95 (típica, sialoadenitis, infiltrado grado III y IV). Conclusiones: La BGSM presenta una baja frecuencia de complicaciones mediatas e inmediatas y un alto rédito en el estudio anatomo-patológico (AU)
Findings of specific antibodies and histopathology data are essential for the diagnosis of Sjögren syndrome (SS). Although the minor salivary gland biopsy (MSGB) is technically simple, it needs to be performed in a medical institution to avoid complications. Objective: To determine the frequency of complications and the usefulness of this technique. Materials and methods: Patients who underwent a minor salivary gland biopsy for a possible diagnosis of SS at Rivadavia Hospital between October 2007 and May 2010 where included. The patients were seen a week and a month after the procedure for follow up. Results: Frequency of acute complications (n = 186): 15 patients; 8.1%, 95%CI: 4.7-13.2 (Bleeding 7.5%, syncope 3.2%, hematoma 2.7%. No accidents occurred). Medium term complications (n = 164): 16 patients: 9.75%, 95%CI: 5.9-15.6 (pain 7.32%, inflammation 3.66%, sensitivity disorders 3.05%, granuloma 1.22%,). No infections or suture dehiscence occurred. Microscopic results: 154 biopsy reports were received: glandular 90.9%, 95%CI: 85-95 (typical, sialadenitis, grade III and IV infiltration). Conclusions: MSGB has very low frequency of medium term and acute complications and it has high usefulness (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Biopsy/methods , Biopsy , Salivary Gland Diseases/complications , Salivary Gland Diseases/diagnosis , Salivary Glands, Minor/cytology , Salivary Glands, Minor/pathology , Salivary Glands, Minor , Sjogren's Syndrome/complications , Immunosuppressive Agents/therapeutic use , Salivary Glands/microbiology , Salivary Glands/pathology , Prospective Studies , Longitudinal Studies , Methotrexate/therapeutic use , Azathioprine/therapeutic useABSTRACT
UNLABELLED: Findings of specific antibodies and histopathology data are essential for the diagnosis of Sjögren syndrome (SS). Although the minor salivary gland biopsy (MSGB) is technically simple, it needs to be performed in a medical institution to avoid complications. OBJECTIVE: To determine the frequency of complications and the usefulness of this technique. MATERIALS AND METHODS: Patients who underwent a minor salivary gland biopsy for a possible diagnosis of SS at Rivadavia Hospital between October 2007 and May 2010 where included. The patients were seen a week and a month after the procedure for follow up. RESULTS: Frequency of acute complications (n=186): 15 patients; 8.1%, 95% CI: 4.7-13.2 (Bleeding 7.5%, syncope 3.2%, hematoma 2.7%. No accidents occurred). Medium term complications (n=164): 16 patients: 9.75%, 95% CI: 5.9-15.6 (pain 7.32%, inflammation 3.66%, sensitivity disorders 3.05%, granuloma 1.22%,). No infections or suture dehiscence occurred. Microscopic results: 154 biopsy reports were received: glandular 90.9%, 95% CI: 85-95 (typical, sialadenitis, grade III and IV infiltration). CONCLUSIONS: MSGB has very low frequency of medium term and acute complications and it has high usefulness.