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1.
Lupus ; 28(11): 1380-1382, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31505994
3.
Biol Res Nurs ; : 1099800418803176, 2018 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-30282476

RESUMO

BACKGROUND AND AIMS: C-reactive protein (CRP) is commonly used as a biomarker for inflammation. Mild elevations of CRP have been seen in chronic autoimmune diseases like systemic lupus erythematosus (SLE), and CRP has been linked to an increased risk of cardiovascular events. Diet quality and certain dietary factors seem to influence CRP levels in healthy subjects. To date, the effect of diet on serum CRP in SLE has not been studied. Our aim was to investigate the relationship between dietary nutrients, antioxidant intake, and serum CRP in SLE. DESIGN AND METHOD: A cross-sectional study was conducted among 91 patients with SLE. High-sensitivity hsCRP values were determined using an immuno-turbidimetry assay in a Beckman Coulter analyzer (AU5800). Dietary intake of macro- and micronutrients was assessed through a 24-hr diet recall. Antioxidant nutrient intake was evaluated using the dietary antioxidant quality score (DAQs). Linear regression models were used to investigate the relationships between serum hsCRP levels, dietary nutrient intake, and DAQs. RESULTS: The mean serum hsCRP level observed (3.76 ± 6.68 mg/L) was above the established normal range. However, participating SLE patients had low-quality diets, and we found no significant correlations between dietary intake of macro- or micronutrients or antioxidant nutrient intake (DAQs) and serum CRP levels. CONCLUSION: Our study reveals that participating SLE patients had a low-quality diet that did not influence inflammatory status measured using serum CRP levels. Further interventional studies with high-quality diets in this population are necessary to dissect the role of diet on CRP levels in SLE.

4.
Lupus ; 27(10): 1718-1722, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29635998

RESUMO

Aim The aim of this study was to evaluate the clinical response to combined therapy with hydroxychloroquine and mepacrine in patients with systemic lupus erythematosus and refractory joint and/or skin disease. Methods Mepacrine was added to 46 systemic lupus erythematosus patients unresponsive to treatment with the following drug combinations: hydroxychloroquine + prednisone + immunosuppressive drugs ( n = 24), hydroxychloroquine + prednisone ( n = 16), hydroxychloroquine + prednisone + retinoids ( n = 2), hydroxychloroquine alone ( n = 1), hydroxychloroquine + one immunosuppressive drug ( n = 1), hydroxychloroquine + prednisone + one immunosuppressive drug + belimumab ( n = 1) or hydroxychloroquine + prednisone + belimumab ( n = 1). The outcome variable was the clinical response, either complete or partial, based on clinical judgement. The Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) and the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score were additionally used. Results A total of 91% patients showed complete/partial response, with similar rates among those with joint or skin disease. In patients with cutaneous activity, a statistically significant decrease in the CLASI was seen. There also was a statistically significant decrease in the SLEDAI. The mean daily dose of prednisone decreased from 5.8 to 3.4 mg/d ( p = 0.001). Prednisone could be discontinued in 20% of patients. No serious adverse events were seen. Smoking was the only predictor of complete response. Conclusion In the setting of refractory skin and/or joint disease, the addition of mepacrine to previous therapy including hydroxychloroquine was safe and effective in reducing disease activity and decreasing prednisone doses. The fact that smokers responded better opens the door to further studying the combination of mepacrine-hydroxychloroquine as a first-line therapy in such patients.


Assuntos
Antimaláricos/uso terapêutico , Hidroxicloroquina/uso terapêutico , Imunossupressores/uso terapêutico , Artropatias/tratamento farmacológico , Lúpus Eritematoso Cutâneo/tratamento farmacológico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Quinacrina/uso terapêutico , Adulto , Antimaláricos/efeitos adversos , Quimioterapia Combinada , Feminino , Humanos , Hidroxicloroquina/efeitos adversos , Imunossupressores/efeitos adversos , Artropatias/diagnóstico , Artropatias/imunologia , Lúpus Eritematoso Cutâneo/diagnóstico , Lúpus Eritematoso Cutâneo/imunologia , Lúpus Eritematoso Discoide/diagnóstico , Lúpus Eritematoso Discoide/tratamento farmacológico , Lúpus Eritematoso Discoide/imunologia , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/imunologia , Masculino , Pessoa de Meia-Idade , Quinacrina/efeitos adversos , Indução de Remissão , Estudos Retrospectivos , Fumantes , Resultado do Tratamento
5.
Rheumatol Int ; 38(3): 363-374, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29322341

RESUMO

OBJECTIVES: To evaluate the clinical characteristics of patients with interstitial lung disease (ILD) in the setting of a large cohort of systemic sclerosis (SSc) patients, and to analyse the differences according to the SSc subtype (following the modification of classification criteria of the American College of Rheumatology for SSc proposed by LeRoy and Medsger), factors are associated with moderate-to-severe impairment of lung function, as well as mortality and causes of death. METHODS: A descriptive study was performed, using the available data from the Spanish Scleroderma Study Group. RESULTS: Twenty-one referral centers participated in the registry. By April 2014, 1374 patients with SSc had been enrolled, and 595 of whom (43%) had ILD: 316 (53%) with limited cutaneous SSc (lcSSc), 240 (40%) with diffuse cutaneous SSc (dcSSc), and 39 (7%) with SSc sine scleroderma (ssSSc). ILD in the lcSSc and the ssSSc subsets tended to develop later, and showed a less impaired forced vital capacity (FVC) and a ground glass pattern on high-resolution computed tomography (HRCT) less frequently, compared with the dcSSc subset. Factors related to an FVC < 70% of predicted in the multivariate analysis were: dcSSc, positivity to anti-topoisomerase I antibodies, a ground glass pattern on HCRT, an active nailfold capillaroscopy pattern, lower DLco, older age at symptoms onset, and longer time between symptoms onset and ILD diagnosis. Finally, SSc-associated mortality and ILD-related mortality were highest in dcSSc patients, whereas that related to pulmonary arterial hypertension was highest in those with lcSSc-associated ILD. CONCLUSIONS: Our study indicates that ILD constitutes a remarkable complication of SSc with significant morbidity and mortality, which should be borne in mind in all three subgroups (lcSSc, dcSSc, and ssSSc).


Assuntos
Doenças Pulmonares Intersticiais , Pulmão , Esclerodermia Difusa , Esclerodermia Limitada , Adulto , Idoso , Causas de Morte , Distribuição de Qui-Quadrado , Feminino , Cardiopatias/mortalidade , Cardiopatias/fisiopatologia , Humanos , Hipertensão Pulmonar/mortalidade , Hipertensão Pulmonar/fisiopatologia , Modelos Logísticos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Pulmão/fisiopatologia , Doenças Pulmonares Intersticiais/diagnóstico , Doenças Pulmonares Intersticiais/mortalidade , Doenças Pulmonares Intersticiais/fisiopatologia , Doenças Pulmonares Intersticiais/terapia , Masculino , Angioscopia Microscópica , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Prevalência , Prognóstico , Sistema de Registros , Fatores de Risco , Esclerodermia Difusa/diagnóstico , Esclerodermia Difusa/mortalidade , Esclerodermia Difusa/fisiopatologia , Esclerodermia Difusa/terapia , Esclerodermia Limitada/diagnóstico , Esclerodermia Limitada/mortalidade , Esclerodermia Limitada/fisiopatologia , Esclerodermia Limitada/terapia , Índice de Gravidade de Doença , Pele/patologia , Espanha/epidemiologia , Tomografia Computadorizada por Raios X , Capacidade Vital
6.
Clin Rheumatol ; 37(4): 999-1009, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29214548

RESUMO

The objective of the study is to determine the importance of the mode of onset as prognostic factor in systemic sclerosis (SSc). Data were collected from the Spanish Scleroderma Registry (RESCLE), a nationwide retrospective multicenter database created in 2006. As first symptom, we included Raynaud's phenomenon (RP), cutaneous sclerosis, arthralgia/arthritis, puffy hands, interstitial lung disease (ILD), pulmonary arterial hypertension (PAH), and digestive hypomotility. A total of 1625 patients were recruited. One thousand three hundred forty-two patients (83%) presented with RP as first symptom and 283 patients (17%) did not. Survival from first symptom in those patients with RP mode of onset was higher at any time than those with onset as non-Raynaud's phenomenon: 97 vs. 90% at 5 years, 93 vs. 82% at 10 years, 83 vs. 62% at 20 years, and 71 vs. 50% at 30 years (p < 0.001). In multivariate analysis, factors related to mortality were older age at onset, male gender, dcSSc subset, ILD, PAH, scleroderma renal crisis (SRC), heart involvement, and the mode of onset with non-Raynaud's phenomenon, especially in the form of puffy hands or pulmonary involvement. The mode of onset should be considered an independent prognostic factor in systemic sclerosis and, in particular, patients who initially present with non-Raynaud's phenomenon may be considered of poor prognosis.


Assuntos
Artralgia/etiologia , Hipertensão Pulmonar/etiologia , Doenças Pulmonares Intersticiais/etiologia , Doença de Raynaud/etiologia , Escleroderma Sistêmico/diagnóstico , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Sistema de Registros , Estudos Retrospectivos , Escleroderma Sistêmico/complicações , Escleroderma Sistêmico/fisiopatologia , Índice de Gravidade de Doença , Avaliação de Sintomas
7.
Rev. clín. esp. (Ed. impr.) ; 217(2): 108-116, mar. 2017. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-160704

RESUMO

Las enfermedades autoinflamatorias son cuadros clínicos con manifestaciones inflamatorias que se presentan de forma periódica o persistente, producidas por alteraciones adquiridas o hereditarias de la respuesta inmune innata. En general, son más frecuentes en la edad pediátrica, pero se han descrito casos en adultos, por lo que son de interés para cualquier especialista. Existen pocas referencias de estas enfermedades en el adulto por su baja prevalencia e infradiagnóstico. El objetivo de este trabajo es revisar la literatura científica sobre estos trastornos para sistematizar sus características clínicas, pronósticas y la respuesta al tratamiento en el adulto (AU)


Autoinflammatory diseases are clinical conditions with inflammatory manifestations that present in a periodic or persistent manner and are caused by acquired or hereditary disorders of the innate immune response. In general, these diseases are more common in childhood, but cases have been reported in adults and are therefore important for all specialists. There are few references on these diseases in adults due to their low prevalence and underdiagnosis. The aim of this study is to review the scientific literature on these disorders to systematise their clinical, prognostic and treatment response characteristics in adults (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Doenças Hereditárias Autoinflamatórias/epidemiologia , Doenças Hereditárias Autoinflamatórias/prevenção & controle , Prognóstico , Febre Familiar do Mediterrâneo/complicações , Febre Familiar do Mediterrâneo/epidemiologia , Síndrome de Behçet/complicações , Doenças Hereditárias Autoinflamatórias/classificação , Herança Multifatorial/genética , MEDLINE/estatística & dados numéricos , Síndromes Periódicas Associadas à Criopirina/complicações , Síndrome de Schnitzler/complicações
8.
Rev Clin Esp ; 217(2): 108-116, 2017 Mar.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27702442

RESUMO

Autoinflammatory diseases are clinical conditions with inflammatory manifestations that present in a periodic or persistent manner and are caused by acquired or hereditary disorders of the innate immune response. In general, these diseases are more common in childhood, but cases have been reported in adults and are therefore important for all specialists. There are few references on these diseases in adults due to their low prevalence and underdiagnosis. The aim of this study is to review the scientific literature on these disorders to systematise their clinical, prognostic and treatment response characteristics in adults.

9.
Lupus ; 25(13): 1470-1478, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27055522

RESUMO

The aim of this study was to investigate the possible effects of corticosteroids in women with systemic lupus erythematosus (SLE) in two processes of executive function: cognitive flexibility and decision-making. To that end, we evaluated 121 women divided into three groups: 50 healthy women, 38 women with SLE not receiving corticosteroid treatment and 33 women with SLE receiving corticosteroid treatment. Cognitive flexibility was measured with the Trail Making Tests A and B; decision-making was measured with the Iowa Gambling Task. Additionally, demographic (age and education level), clinical (SLE Disease Activity Index (SLEDAI), Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (SDI) and disease duration) and psychological characteristics (stress vulnerability, perceived stress and psychopathic symptomatology) were evaluated. The results showed that both SLE groups displayed poorer decision-making than the healthy women ( p = 0.006) and also that the SLE group receiving corticosteroid treatment showed lower cognitive flexibility than the other two groups ( p = 0.030). Moreover, SLE patients showed poorer scores than healthy women on the following SCL-90-R subscales: somatisation ( p = 0.005), obsessions and compulsions ( p = 0.045), depression ( p = 0.004), hostility ( p = 0.013), phobic anxiety ( p = 0.005), psychoticism ( p = 0.016) and positive symptom total ( p = 0.001). In addition, both SLE groups were more vulnerable to stress ( p = 0.000). These findings help to understand the effects of corticosteroid treatment on cognitive flexibility and decision-making, in addition to the disease-specific effects suffered by women with SLE.


Assuntos
Corticosteroides/farmacologia , Cognição/efeitos dos fármacos , Tomada de Decisões/efeitos dos fármacos , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Corticosteroides/administração & dosagem , Adulto , Feminino , Humanos , Lúpus Eritematoso Sistêmico/psicologia , Pessoa de Meia-Idade , Índice de Gravidade de Doença
12.
Medicine (Baltimore) ; 94(43): e1728, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26512564

RESUMO

Systemic sclerosis (SSc) is a rare, multisystem disease showing a large individual variability in disease progression and prognosis. In the present study, we assess survival, causes of death, and risk factors of mortality in a large series of Spanish SSc patients. Consecutive SSc patients fulfilling criteria of the classification by LeRoy were recruited in the survey. Kaplan-Meier and Cox proportional-hazards models were used to analyze survival and to identify predictors of mortality. Among 879 consecutive patients, 138 (15.7%) deaths were registered. Seventy-six out of 138 (55%) deceased patients were due to causes attributed to SSc, and pulmonary hypertension (PH) was the leading cause in 23 (16.6%) patients. Survival rates were 96%, 93%, 83%, and 73% at 5, 10, 20, and 30 years after the first symptom, respectively. Survival rates for diffuse cutaneous SSc (dcSSc) and limited cutaneous SSc were 91%, 86%, 64%, and 39%; and 97%, 95%, 85%, and 81% at 5, 10, 20, and 30 years, respectively (log-rank: 67.63, P < 0.0001). The dcSSc subset, male sex, age at disease onset older than 65 years, digital ulcers, interstitial lung disease (ILD), PH, heart involvement, scleroderma renal crisis (SRC), presence of antitopoisomerase I and absence of anticentromere antibodies, and active capillaroscopic pattern showed reduced survival rate. In a multivariate analysis, older age at disease onset, dcSSc, ILD, PH, and SRC were independent risk factors for mortality. In the present study involving a large cohort of SSc patients, a high prevalence of disease-related causes of death was demonstrated. Older age at disease onset, dcSSc, ILD, PH, and SRC were identified as independent prognostic factors.


Assuntos
Sistema de Registros , Escleroderma Sistêmico/mortalidade , Adulto , Idoso , Causas de Morte , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Espanha/epidemiologia
13.
Lupus ; 24(13): 1356-63, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26162685

RESUMO

Antiphospholipid syndrome is considered a high risk factor for any kind of surgery. Considering that all solid organ transplants are critically dependent on the patency of vascular anastomosis, there is much concern about the consequences this pro-thrombotic condition may have on transplantation. Relatively little information is available in the literature assessing the real risk that antiphospholipid syndrome or the presence of antiphospholipid antibodies represent in solid organ transplantation. The aim of this article is to review the literature related to transplantation of solid organs in patients diagnosed with antiphospholipid syndrome or patients with positive antiphospholipid antibodies.


Assuntos
Anticorpos Antifosfolipídeos/imunologia , Síndrome Antifosfolipídica/diagnóstico , Transplante de Órgãos , Anticorpos Anticardiolipina/imunologia , Síndrome Antifosfolipídica/imunologia , Síndrome Antifosfolipídica/cirurgia , Feminino , Humanos , Inibidor de Coagulação do Lúpus/imunologia , Pessoa de Meia-Idade , Fatores de Risco , Trombofilia/diagnóstico , Trombofilia/etiologia , Trombofilia/terapia , Trombose/imunologia , Trombose/fisiopatologia , Imunologia de Transplantes , Resultado do Tratamento
14.
Lupus ; 24(8): 875-9, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25697771

RESUMO

OBJECTIVE: To analyze the role of the antiphospholipid autoantibodies (aPL) on the neuropsychological deficits in systemic lupus erythematosus (SLE) patients, comparing groups of patients with antiphospholipid syndrome (APS; n = 15), SLE with aPL (n = 12), and SLE without aPL (n = 27), and a healthy control group (n = 31). METHODS: Patients fulfilled the American College of Rheumatology SLE classification criteria or the Sydney criteria for APS. All participants were woman, and groups were matched on age and education. A standardized cognitive examination classified patients as cognitively declined or impaired according to the American College of Rheumatology. RESULTS: Differences between the groups were found in all of the studied variables, comprising attention and executive functions (sustained and selective attention, fluency, and inhibition), and memory (verbal and visual). Post-hoc analyses showed cognitive performance was equivalent between APS and SLE with aPL. Differences between SLE without aPL and control groups were found only in four of the 10 studied variables, while differences in all but two memory variables were found between SLE without aPL and control groups. Furthermore, cognitive deficit was three times more frequent in APS and SLE with aPL patients than for the control group (80%, 75%, and 16%, respectively), and two times more frequent compared to SLE patients without aPL (48%). CONCLUSIONS: Our results support the relationship between aPL and cognitive symptoms in SLE. Also, almost half of the patients with SLE and no aPL showed cognitive problems, pointing to the multifactorial causes of cognitive problems in SLE. Future research with larger sample size is guaranteed to replicate our results.


Assuntos
Anticorpos Antifosfolipídeos/imunologia , Síndrome Antifosfolipídica/imunologia , Transtornos Cognitivos/epidemiologia , Vasculite Associada ao Lúpus do Sistema Nervoso Central/imunologia , Vasculite Associada ao Lúpus do Sistema Nervoso Central/psicologia , Adulto , Atenção , Função Executiva , Feminino , Humanos , Memória , Pessoa de Meia-Idade
15.
Lupus ; 24(2): 130-7, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25199808

RESUMO

Pyoderma gangrenosum (PG) is an uncommon, distinctive cutaneous ulceration which is usually idiopathic, but may be associated with many systemic disorders. The etiopathogenesis of PG is still not well understood. PG is part of the spectrum of the neutrophilic dermatoses and it has been proposed as a prototype of cutaneous autoinflammatory disease. PG usually has a good outcome under immunosuppressive treatment. Although PG has been associated with several systemic diseases, it has rarely been reported in association with systemic lupus erythematosus (SLE). In this article we report five cases of SLE-related PG and review the literature. Our findings support the possible relationship between active SLE and PG, although the mechanism remains unclear. Clinical manifestations, used treatments and outcomes of SLE-related PG do not differ from the described for the general population.


Assuntos
Imunossupressores/uso terapêutico , Lúpus Eritematoso Sistêmico/complicações , Pioderma Gangrenoso/etiologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pioderma Gangrenoso/tratamento farmacológico , Pioderma Gangrenoso/patologia
16.
Ann Rheum Dis ; 73(9): 1742-5, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24919468

RESUMO

OBJECTIVE: Different lines of evidence have highlighted the role of IL-17A in the inflammatory process occurring in giant cell arteritis (GCA). The aim of the present study was to assess whether the IL17A locus influences GCA susceptibility and its clinical subphenotypes. METHODS: We carried out a large meta-analysis including a total of 1266 biopsy-proven GCA patients and 3779 healthy controls from four European populations (Spain, Italy, Germany and Norway). Five IL17A polymorphisms (rs4711998, rs8193036, rs3819024, rs2275913 and rs7747909) were selected by tagging and genotyped using TaqMan assays. Allelic combination and dependency tests were also performed. RESULTS: In the pooled analysis, two of the five analysed polymorphisms showed evidence of association with GCA (rs2275913: PMH=1.85E-03, OR=1.17 (1.06-1.29); rs7747909: PMH=8.49E-03, OR=1.15 (1.04-1.27)). A clear trend of association was also found for the rs4711998 variant (PMH=0.059, OR=1.11 (1.00-1.23)). An independent effect of rs2275913 and rs4711998 was evident by conditional regression analysis. In addition, the haplotype harbouring the risk alleles better explained the observed association than the polymorphisms independently (likelihood p value <10(-05)). CONCLUSIONS: Polymorphisms within the IL17A locus show a novel association with GCA. This finding supports the relevant role of the Th17 cells in this vasculitis pathophysiology.


Assuntos
Arterite de Células Gigantes/genética , Interleucina-17/genética , Estudos de Casos e Controles , Frequência do Gene , Predisposição Genética para Doença , Genótipo , Haplótipos , Humanos , Polimorfismo Genético
19.
Ann Rheum Dis ; 72(11): 1882-1886, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23946333

RESUMO

OBJECTIVE: To analyse the role of the PTPN22 and CSK genes, previously associated with autoimmunity, in the predisposition and clinical phenotypes of giant cell arteritis (GCA). METHODS: Our study population was composed of 911 patients diagnosed with biopsy-proven GCA and 8136 unaffected controls from a Spanish discovery cohort and three additional independent replication cohorts from Germany, Norway and the UK. Two functional PTPN22 polymorphisms (rs2476601/R620W and rs33996649/R263Q) and two variants of the CSK gene (rs1378942 and rs34933034) were genotyped using predesigned TaqMan assays. RESULTS: The analysis of the discovery cohort provided evidence of association of PTPN22 rs2476601/R620W with GCA (PFDR=1.06E-04, OR=1.62, CI 95% 1.29 to 2.04). The association did not appear to follow a specific GCA subphenotype. No statistically significant differences between allele frequencies for the other PTPN22 and CSK genetic variants were evident either in the case/control or in stratified case analysis. To confirm the detected PTPN22 association, three replication cohorts were genotyped, and a consistent association between the PTPN22 rs2476601/R620W variant and GCA was evident in the overall meta-analysis (PMH=2.00E-06, OR=1.51, CI 95% 1.28 to 1.79). CONCLUSIONS: Our results suggest that the PTPN22 polymorphism rs2476601/R620W plays an important role in the genetic risk to GCA.


Assuntos
Arterite de Células Gigantes/genética , Proteína Tirosina Fosfatase não Receptora Tipo 22/genética , Quinases da Família src/genética , Estudos de Casos e Controles , Estudos de Coortes , Frequência do Gene , Predisposição Genética para Doença , Humanos , Polimorfismo Genético , Polimorfismo de Nucleotídeo Único , Reação em Cadeia da Polimerase em Tempo Real
20.
Lupus ; 22(10): 987-95, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23963430

RESUMO

OBJECTIVE: The objectives of this paper are to compare sexual function and distress in women with systemic lupus erythematosus (SLE) and in healthy controls; to determine the association between disease characteristics, quality of life, psychopathology and sexual function; and to compare sexual function and distress of women according to age (reproductive and nonreproductive-age women). METHODS: We conducted a cross-sectional study of 120 participants; 65 women had SLE (aged 18-65), and 55 were healthy, age-matched controls. The assessment included the Female Sexual Function Index (FSFI), Symptom Checklist-90-Revised (SCL-90-R), Short Form 36 health survey (SF-36), socio-demographic characteristics and the Systemic Lupus International Collaborating Clinics (SLICC) and SLE Disease Activity Index (SLEDAI) in SLE patients only. RESULTS: Of 65 eligible patients with SLE, 61 (94%) responded; of 55 control subjects, 53 (96%) responded. The FSFI total score and subscale scores for desire, arousal, lubrication, orgasm and pain were significantly lower in patients with SLE. More somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, phobia, paranoid ideation, psychoticism, the Positive Symptom Total (PST), Positive Score Discomfort Index (PSDI), the use of psychotropic drugs, general health, vitality, social function, emotional role and mental health were significantly associated with changes in the patient group's sexuality. Multivariate analysis indicated that depression, PSDI and vitality were the variables significantly associated with low sexual function in patients with SLE. CONCLUSIONS: Women with SLE reported significantly impaired sexual function compared with healthy controls. Impaired sexual function was associated with somatization, obsessive-compulsive behavior, interpersonal sensitivity, depression, hostility, paranoid ideation, psychoticism, PST, higher scores in the PSDI subscale, vitality, social functioning and mental health. These results indicate that, in daily practice, inquiring about sexuality and quality of life and screening for psychopathology are important for every patient with SLE, irrespective of their clinical characteristics.


Assuntos
Lúpus Eritematoso Sistêmico/psicologia , Comportamento Sexual , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Análise Multivariada , Qualidade de Vida
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