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Abstract Number: 521

Respiratory Compromise In Patients With Primary Sjögren Syndrome

Evangelina Maria Miretti1, Maria Haye Salinas2, Francisco Caeiro1, Anastasia Secco3, Antonio Catalan Pellet4, Paula Pucci5, Cecilia Asnal6, Catherine Crow7, Cristina Amitrano8, Alejandro Nitsche8, Silvia Papassidero9, Oscar L. Rillo10, Federico Zazzetti11, Juan C. Barreira12, Mariano Rivero12, Damián Duartes Noé13, Hugo A. Laborde13, Natalia Tamborenea14, Eduardo Albiero15, Maria Renata Seisdedos16, Carla Gobbi17, Paula Alba18, Pablo Astesana19, Gabriela Salvatierra20 and Veronica Saurit1, 1Rheumatology, Hospital Privado Centro Médico de Córdoba, Córdoba, Argentina, 2Reumatología, Hospital Privado de Córdoba, Córdoba, Argentina, 3Rheumathology, Hospital Bernardino Rivadavia, Buenos aires, Argentina, 4Rheumatology, Hospital Rivadavia, Buenos Aires, Argentina, 5Rheumatology, Aleman Hospital, Argentina, buenos Aires, Argentina, 6Rheumatology, Argerich, Buenos Aires, Argentina, 7Rheumatology, Hospital Alemán, Buenos aires, Argentina, 8Rheumatology, Hospital Alemán, Buenos Aires, Argentina, 9Rheumatology, Hospital Tornú, Buenos Aires, Argentina, 10Rheumatology Unit, Hospital General de Agudos Dr. E. Tornú, Buenos Aires, Argentina, 11Rheumatology, Hospital Británico, Buenos Aires, Argentina, 12Rheumatology, British Hospital, Buenos Aires, Argentina, 13Rheumatology, Buenos Aires British Hospital, Buenos Aires, Argentina, 14Rheumatology, OMI, Buenos Aires, Argentina, 15Rheumatology, Sanatorio Allende de Córdoba, Córdoba, Argentina, 16Rheumatology, Rivadavia Hospital, Buenos Aires, Argentina, 17Rheumatology, Sanatorio Allende de Córdoba, Cordoba, Argentina, 18Rheumatology, Hospital Córdoba, Córdoba, Argentina, 19Sanatorio Allende, cordoba, Argentina, 20Rheumatology, Centro de enfermedades Reumaticas, Santiago Del Estero, Argentina

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Lung Disease and Sjogren's syndrome

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Session Information

Title: Sjögren's Syndrome: Clinical Aspects

Session Type: Abstract Submissions (ACR)

Background/Purpose:


Sj
ögren’s syndrome (SS) is an autoimmune inflammatory disease that affects exocrine glands and may have extraglandular involvement. The respiratory compromise (RC) occurs in 19% – 65% of the patients with SS and the most common type is nonspecific interstitial pneumonia (NSIP) (30-60%).

Objectives: To determine the frequency, time of occurrence and type of RC in patients with primary SS. To establish the relationship between RC and antibody profile, complement levels, leukopenia, and other extraglandular manifestations.

Methods:

Observational, transversal and analytical study. We included patients who met ACR-EULAR criteria for primary Sjögren’s syndrome, over 18 years old from the GESSAR (argentine SS study group) database from Jan/2011 to Jul/2011 inclusive. We evaluated demographic data, time of evolution, the presence of extraglandular manifestations and laboratory parameters. Categorical variables were compared with X2 test or Fisher test and continuous variables with the Mann-Whitney test, The p was considered significant when ≤ 0.05. We performed multivariate logistic regression analysis.

Results:


Total N: 285. 95.9% female, age 55.8 ± 14.8 y. Time of evolution of SS until the RC developed: 4 years (IQR 2-6 a). 75 patients (26.3%) had RC, of which the most frequent were xerotrachea (58,6%), recurrent infections (24%), NSIP (13,3%) and pulmonary fibrosis (12.5) (Box 1). RC was more common in patients with Raynaud syndrome (22.2% vs 12.3%, p = 0.04),
fibromyalgia (26.8% vs 14.3%, p: 0.01) and tinnitus (5.9% vs 1.2%, p: 0.050). There were no significant differences in laboratory parameters. In the multivariate logistic regression analysis there was an independent association of with Raynaud’s (OR = 2.32, 95% CI 1.08 to 4.96, P = 0.03) and fibromyalgia (OR = 2.50, 95% CI 1.21 to 5.13, p = 0, 01) with RC


Conclusion:


A quarter of patients with SS had RC of which the most frequent were xerotraquea, recurrent infections, NSIP and pulmonary fibrosis. There was no association with laboratory parameters. RC was independently associated with the presence of lung disease raynaud and fibromyalgia.

The authors declare no conflicts of interest.

Table 1: Distribution of the Types of Respiratory Compromise

Xerotrachea n (%)

44 (58,6)

Recurrent infections n (%)

18 (24)

Nonspecific interstitial pneumonia (NSIP) n (%)

10 (13,3)

Pulmonary fibrosis (UIP) n (%)

9 (12,5)

Lymphocytic interstitial pneumonia n (%)

3 (4)

Pulmonary hipertensión n (%)

2 (2,6)

Pulmonary thromboembolism  n (%)

2 (2,6)

Bronchiectasis n (%)

2 (2,6)

Bronchiolitis obliterans n (%)

2 (2,6)

Pleural effusion n (%)

1 (1,3)

Nonspecific interstitial pneumonia n (%)

1 (1,3)

Solitary nodule n (%)

1 (1,3)


Disclosure:

E. M. Miretti,
None;

M. Haye Salinas,
None;

F. Caeiro,
None;

A. Secco,
None;

A. Catalan Pellet,
None;

P. Pucci,
None;

C. Asnal,
None;

C. Crow,
None;

C. Amitrano,
None;

A. Nitsche,
None;

S. Papassidero,
None;

O. L. Rillo,
None;

F. Zazzetti,
None;

J. C. Barreira,
None;

M. Rivero,
None;

D. Duartes Noé,
None;

H. A. Laborde,
None;

N. Tamborenea,
None;

E. Albiero,
None;

M. R. Seisdedos,
None;

C. Gobbi,
None;

P. Alba,
None;

P. Astesana,
None;

G. Salvatierra,
None;

V. Saurit,
None.

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