[Sexual function in married women with rheumatoid arthritis]. / Dysfonction sexuelle chez dix femmes mariées atteintes de polyarthrite rhumatoïde.

OBJECTIVE: The aim of this study is to assess sexual functioning in a group of married women with rheumatoid arthritis using a self-questionnaire. METHODS: This is a horizontal study for descriptive and analytical purposes. (between October and November 2010). Married women with a confirmed diagnosis of rheumatoid arthritis (RA), with no co morbidities that may affect sexual activity, were interviewed about their sexual functioning and their quality of life by a self report questionnaire. RESULTS: A total of 10 patients who met the criteria have accepted to participate to the study. Their mean age was 42.5±5.8 years (32-50 years), their mean age at the marriage was 24.8±8.9 years (16-48 years). Six women thought that the disease had affected their sexual relationship and their sexual activity. Six patients reported a decrease in the frequency of intercourse since the onset of their disease. The reported mean age at the beginning of sexual (SD) dysfunction was 37.1±5.8 years (30-48 years). Six of the sample reported a diminished desire for a sexual relationship since the disease onset. The reasons were pain, physical disability and fatigue. The assessment of sexual functioning using the Female sexual function index (FSFI) showed a mean FSFI score at 19.2±9.8 (2-30) with seven women scoring in the range associated with clinical SD (<26). All the subscales were affected: desire, arousal, lubrication, orgasm and satisfaction. Our patients reported a mean total score on World Health Quality of Life-Brief Version (WHOQOL-brief) of 60 out of 120 indicating a moderate altered quality of life. CONCLUSION: The prevalence of sexual dysfunction in women with RA is high when a specific questionnaire is used to assess it. The reasons for disturbed sexual functioning are multifactorial: impaired function, chronic pain and important fatigue.

Systemic lupus erythematosusmyositis overlap syndrome: report of 6 cases.

The incidence of myositis in patients with systemic lupus erythematosus (SLE) is low among different series. Here we attempt to describe the main features of SLE/myositis overlap syndrome. We retrospectively reviewed the medical records of 174 patients with SLE seen over 15-year period. All the patients fulfilled the revised American Rheumatology Association criteria for SLE. Patients who met The Bohan and Peter criteria for definite myositis were included in this study. Among those patients, six patients had an associated myositis (3.4% overall). They were 6 women with a mean age of 29 years (20-41 years). At the initial evaluation, 3 patients (50%) were complained from myalgia, and all patients had symmetrical muscle weakness (proximal muscle weakness in 6 cases with distal muscle weakness in 2 cases). The muscle disease was severe in 1 case. Involvements of muscles of the pharynx and upper esophagus were noted in 4 patients (66.6%). The creatine kinase (CK) levels were elevated in 4 cases with a mean rate of 2153.5 UI/L. The electromyogram (EMG) revealed signs of myositis in 5 cases. Muscle biopsy, performed in 5 patients, revealed an inflammatory myopathy changes in 4 cases. Antinuclear antibodies (ANA) were positive in all cases. All our patients were treated with high doses of corticosteroids with favorable outcome. Relapse of SLE disease had occurred in 2 patients. The association SLE-myositis is rare with heterogeneous presentation. Through our observations and literature data we will specify the characteristics of this association.