ABSTRACT
Background: Dry eye disease is common among patients with primary Sjögren's syndrome (pSS). Hydroxychloroquine (HCQ), known for its immunomodulatory effects and minimal adverse effects, has emerged as a pivotal treatment option for pSS. Nonetheless, conflicting evidence exists regarding the therapeutic efficacy of HCQ in managing dry eye disease associated with pSS. Objectives: To evaluate the safety and efficacy of oral hydroxychloroquine in treating dry eye disease associated with pSS. Methods: A prospective randomized controlled study was conducted, enrolling pSS patients with moderate to severe dry eye disease. Participants were randomly assigned to an oral HCQ group and an observation group. Various scales (ESSDAI, ESSPRI, OSDI, and SPEED questionnaire score), dry eye-related tests (OSS score, TBUT, and Schirmer test I), ophthalmology-specific tests (BCVA, SD-OCT RT, field of view, latency and amplitudes for multifocal ERG ring 1 and ring 2), whole body protein levels (serum IgA, IgG, and IgM), and blood glucose were assessed before and after 12 months of treatment. Results: Pairwise comparison of the observed indicator baseline revealed no statistical significance (P > .05). After 12 months, the HCQ group exhibited notable improvements in ESSPRI, serum IgA, and Schirmer test I results compared to the control group (P < .05). Both groups demonstrated significant improvements in BCVA, OSDI, SPEED scores, and dry eye-associated examinations compared to baseline (P < .05). Serum IgG and IgM levels decreased in the HCQ group after 12 months of treatment, but without statistical significance (P > .05). None cases of HCQ retinopathy were reported during follow-up. Conclusions: Oral HCQ was demonstrated safety and efficacy in managing pSS-related dry eye disease. Treatment with Oral HCQ markedly reduced the ESSPRI score, improve patients' systemic dryness symptoms, and greatly decreased blood IgA levels. Combined with topical cyclosporin, HCQ improved Schirmer test I scores and alleviated ocular surface inflammation and dry eye signs and symptoms.
Subject(s)
Dry Eye Syndromes , Sjogren's Syndrome , Humans , Sjogren's Syndrome/complications , Sjogren's Syndrome/drug therapy , Sjogren's Syndrome/diagnosis , Hydroxychloroquine/adverse effects , Prospective Studies , Dry Eye Syndromes/drug therapy , Dry Eye Syndromes/etiology , Immunoglobulin A/therapeutic use , Immunoglobulin G , Immunoglobulin M/therapeutic useABSTRACT
BACKGROUND: Positron emission tomography-computed tomography (PET-CT) and bone marrow biopsy are currently the common clinical examination of lymphoma infiltration. The aim of this research is to evaluate the value of PET-CT in diagnosis of bone marrow infiltration, clinical staging and pathological typing of lymphoma. METHODS: 153 cases were analyzed retrospectively to compare the consistency of PET-CT and bone marrow biopsy. We analyzed the sensitivity, accuracy and specificity of PET-CT in different clinical pathology of lymphoma. RESULTS: The PET-CT sensitivity in detecting bone marrow infiltration is 54.3% with a specificity of 80.5% and accuracy of 74.5%. In aggressive B-cell lymphoma (DLBCL, HG-BL) and MZL, PET-CT results of bone marrow infiltration showed high accuracy of 88.1% and 83.3% respectively. The median value of SUVmax in the patients detected to have bone marrow infiltration by BMB was significantly higher than patients with BMB negative results among subgroups of aggressive B-cell lymphoma, MZL and T-NHL (p<.05). CONCLUSION: PET-CT is significant in detecting bone marrow infiltration in certain pathological types of lymphoma. However pathological inconsistencies still exist between bone marrow biopsy and PET-CT, thus PET-CT cannot completely replace biopsy
ANTECEDENTES: La tomografía computarizada por emisión de positrones (PET/TC) y la biopsia de médula ósea (BMB) son actualmente los exámenes clínicos comunes para valorar la infiltración linfomatosa. El objetivo de este estudio es evaluar el valor de la PET/TC en el diagnóstico de la infiltración de la médula ósea, la estadificación clínica y la tipificación patológica del linfoma. MÉTODOS: Se analizaron retrospectivamente 153 casos para comparar la consistencia de la PET/TC y la BMB. Analizamos la sensibilidad, la fiabilidad y la especificidad de la PET/TC en las diferentes enfermedades clínicas del linfoma. RESULTADOS: La sensibilidad de la PET/TC para detectar infiltración de la médula ósea es del 54,3%, con una especificidad del 80,5% y una precisión del 74,5%. En los casos de linfoma agresivo de células B (DLBCL, HG-BL) y MZL, los resultados de la PET/TC para la infiltración de la médula ósea reflejaron una alta precisión del 88,1 y 83,3%, respectivamente. El valor medio SUVmáx en los pacientes en los que se detectó infiltración de la médula ósea mediante BMB fue significativamente superior al de los pacientes con resultados negativos de BMB entre los subgrupos de linfoma agresivo de células B, MZL y T-NHL (p < 0,05). CONCLUSIÓN: La PET/TC es significativa a la hora de detectar infiltración de la médula ósea en ciertos tipos patológicos de linfoma. Sin embargo, siguen existiendo inconsistencias patológicas entre la biopsia de médula ósea y la PET/TC, aunque esta técnica no puede sustituir por completo a la biopsia
Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Aged , Bone Marrow/diagnostic imaging , Fluorodeoxyglucose F18 , Positron Emission Tomography Computed Tomography/methods , Lymphoma/diagnostic imaging , Reproducibility of Results , Retrospective Studies , Lymphoma/pathology , Sensitivity and SpecificityABSTRACT
BACKGROUND: Positron emission tomography-computed tomography (PET-CT) and bone marrow biopsy are currently the common clinical examination of lymphoma infiltration. The aim of this research is to evaluate the value of PET-CT in diagnosis of bone marrow infiltration, clinical staging and pathological typing of lymphoma. METHODS: 153 cases were analyzed retrospectively to compare the consistency of PET-CT and bone marrow biopsy. We analyzed the sensitivity, accuracy and specificity of PET-CT in different clinical pathology of lymphoma. RESULTS: The PET-CT sensitivity in detecting bone marrow infiltration is 54.3% with a specificity of 80.5% and accuracy of 74.5%. In aggressive B-cell lymphoma (DLBCL, HG-BL) and MZL, PET-CT results of bone marrow infiltration showed high accuracy of 88.1% and 83.3% respectively. The median value of SUVmax in the patients detected to have bone marrow infiltration by BMB was significantly higher than patients with BMB negative results among subgroups of aggressive B-cell lymphoma, MZL and T-NHL (p<.05). CONCLUSION: PET-CT is significant in detecting bone marrow infiltration in certain pathological types of lymphoma. However pathological inconsistencies still exist between bone marrow biopsy and PET-CT, thus PET-CT cannot completely replace biopsy.
