Session Information
Date: Tuesday, November 10, 2015
Title: Reproductive Issues in Rheumatic Disorders: Basic and Clinical Aspects Poster Session
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: 1. To study the effect of pregnancy in PSS patients on oral and ocular dryness and the salivary test for dental caries activity. 2. To study the effect of pregnancy on thyroid function in PSS patients with positive anti-thyroid antibodies (anjti-thyroglobulin and / or anti-peroxidase).
Methods: A prospective study was conducted throughout pregnancy in 12 PSS patients.
The following tests were performed at first visit and then monthly until the end of pregnancy: Schirmer tear secretion test; Whole saliva test (Heintze et al); Questionnaire on oral symptoms (Neidermaier 1998); Questionnaire on dry-eye symptoms (DEQ) (Begley et al).
To test dental caries activity, saliva samples were obtained from all patients during the first month of pregnancy and again at 3, 6 and 9 months. The following tests were performed: CRT® Buffer test was used to determine the buffering capacity of saliva to reduce pH changes; Alban® test) (0-4) was used to measure the ability of saliva to produce acid because of the microorganisms it contains; CRT bacteria system for LB and SM® was used to measure salivary levels of Lactobacillus (LB) and Streptococcus mutans(SM).
Thyroid function was prospectively studied during pregnancy in those PSS patients with positive anti-thyroglobulin and / or anti-peroxidase antibodies (n=10). At the first visit, then monthly to the end of pregnancy, TSH and free T4 were measured in all patients.
Results:
1. No significant changes in Schirmer test or whole saliva test results were observed during pregnancy. No significant changes were observed in the results of the two questionnaires.
2. The results of caries activity tests are presented in the table below:
|
|
Patients with PSS during pregnancy (n=12) |
|||
|
1 month |
3 months |
6 months |
9 months |
|
|
CRT buffer (pH) – mean (SD) |
4.9 (0.5) |
4.6 (1.1) |
4.3 (0.6) |
4.0 (1.0) |
|
Alban test (0-4) – mean (SD) |
3.2 (0.3) |
3.4 (0.4) |
3.4 (0.6) |
3.6 (1.1) |
|
CRT bacteria for LB (% patients with levels ≥100.000 CFUs/mL saliva) |
73.2 |
81.2 |
81.8 |
84.4 |
|
CRT bacteria for MS (% patients with levels ≥100.000 CFUs/mL saliva) |
69.5 |
70.1 |
82.9 |
83.3 |
3. Four patients presented normal physiological changes in thyroid function during pregnancy. Three patients showed higher than normal TSH levels while maintaining normal free T4 levels. Three patients had elevated free T4 during pregnancy. Five patients were prescribed treatment with levothyroxine to maintain TSH levels within the range recommended during pregnancy.
Conclusion:
Pregnancy did not significantly alter the characteristics of xerophthalmia and xerostomia in patients with primary SS. However, periodic salivary tests for dental caries risk showed a gradual decline in the buffering capacity of these patients’ saliva, as well as an increase ability to produce acid. The proportion of patients with high SM and LB values also increased as pregnancy progressed.
The presence of anti-thyroid antibodies, a common finding in patients with PSS, is a risk factor for the development of hypothyroidism during pregnancy.
To cite this abstract in AMA style:
Trujillo E, Trujillo MDM, Padron E, Garcia-Gonzalez M, Exposito L, Sanchez H, Garcia S. Primary Sjögren’s Syndrome and Pregnancy: Evolution of Thyroid Function, Xerostomia, Xerophthalmia and Salivary Test for Dental Caries Risk [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/primary-sjogrens-syndrome-and-pregnancy-evolution-of-thyroid-function-xerostomia-xerophthalmia-and-salivary-test-for-dental-caries-risk/. Accessed .« Back to ACR/ARHP Annual Meeting 2015
ACR Meeting Abstracts - https://acrabstracts.org/abstract/primary-sjogrens-syndrome-and-pregnancy-evolution-of-thyroid-function-xerostomia-xerophthalmia-and-salivary-test-for-dental-caries-risk/