Esophageal abnormalities in juvenile localized scleroderma: is it associated with other extracutaneous manifestations?
Carregando...
Citações na Scopus
3
Tipo de produção
article
Data de publicação
2017
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCIENCE INC
Autores
VALOES, Clarissa C. M.
Citação
REVISTA BRASILEIRA DE REUMATOLOGIA, v.57, n.6, p.521-525, 2017
Resumo
Objective: To assess esophageal involvement (EI) in juvenile localized scleroderma (JLS) population and the possible association between this gastrointestinal manifestation and demographic data, clinical features, laboratory exams, treatments and outcomes. Methods: For a period of 30 years, 5881 patients with rheumatic diseases were followed in our Pediatric Rheumatology Division. EI was defined by the presence of symptoms (solid/liquid dysphagia, heartburn, esophageal regurgitation, nausea/vomiting and epigastralgia) and confirmed by at least one EI exam abnormality: barium contrast radiography, upper gastrointestinal endoscopy and 24-hour esophageal pH-monitoring. Results: JLS was observed in 56/5881 patients (0.9%), mainly linear morphea subtype. EI was observed in 23/56(41%) of JLS patients. Eight(35%) of 23 EI patients with JLS were symptomatic and presented heartburn(5/8), solid and liquid dysphagia(3/8), nausea and epigastralgia(1/8). The frequency of any cumulative extracutaneous manifestations (calcinosis, arthritis/arthralgia, central nervous system, interstitial pneumonitis, mesangial nephritis and/or arrhythmia) was significantly higher in JLS patients with EI compared to those without this complication (56% vs. 24%, p = 0.024). No differences were evidenced in demographic data, JLS subtypes and in each extracutaneous manifestation in both groups (p > 0.05). The frequency of methotrexate use was significantly higher in JLS patients with EI compared to those without (52% vs. 12%, p = 0.002). Autoantibody profile (antinuclear antibodies, antiSCL-70, rheumatoid factor, anticentromere, anti-cardiolipin, anti-Ro/SSA and anti-La/SSB) was similar in both groups (p > 0.05). Conclusions: Our study demonstrated that EI was frequently observed in JLS patients, mainly in asymptomatic patients with linear subtype. EI occurred in JLS patients with other extra cutaneous manifestations and required methotrexate therapy. (C) 2016 Published by Elsevier Editora Ltda.
Palavras-chave
Juvenile localized scleroderma, Gastrointestinal, Esophagus, Methotrexate, Children
Referências
- BIRDI N, 1993, ARTHRITIS RHEUM, V36, P410, DOI 10.1002/art.1780360318
- Carlson DA, 2015, CURR RHEUMATOL REP, V17, DOI 10.1007/s11926-014-0475-y
- Couto SB, 2017, REV BRAS REUMATOL, V57, P613, DOI 10.1016/j.rbre.2014.08.004
- DIAZPEREZ JL, 1980, ARCH DERMATOL, V116, P169, DOI 10.1001/archderm.116.2.169
- FLICK JA, 1988, PEDIATRICS, V82, P107
- Foeldvari I, 2013, RHEUM DIS CLIN N AM, V39, P905, DOI 10.1016/j.rdc.2013.05.003
- Giacomin MFA, 2016, REV BRAS REUMATOL, V56, P82, DOI [10.1016/j.rbr.2014.05.004, 10.1016/j.rbre.2014.05.004]
- Guariso G, 2007, CLIN EXP RHEUMATOL, V25, P786
- Laxer RM, 2006, CURR OPIN RHEUMATOL, V18, P606, DOI 10.1097/01.bor.0000245727.40630.c3
- Vandenplas Y, 2009, J PEDIATR GASTR NUTR, V49, P498, DOI 10.1097/MPG.0b013e3181b7f563
- Weber P, 2000, J RHEUMATOL, V27, P2692
- Wipff J, 2005, ARTHRITIS RHEUM, V52, P2882, DOI 10.1002/art.21261
- Zulian F, 2006, RHEUMATOLOGY, V45, P614, DOI 10.1093/rheumatology/kei251
- Zulian F, 2005, ARTHRITIS RHEUM, V52, P2873, DOI 10.1002/art.21264
- Zulian F, 2013, CURR OPIN RHEUMATOL, V25, P643, DOI 10.1097/BOR.0b013e3283641f61