BACKGROUNDAbout 5-10% of patients with Sjögren's syndrome (SS) will develop non-Hodgkin's lymphoma, presenting a 16 to 44 increased risk compared to the general population. The relationship between SS and other types of cancers has not been much described in the literature. METHODSA total of 1,010 consecutive patients were included in the Brazilian Sjögren's syndrome registry (RE-BRASS), fulfilling the 2002/2016 classification criteria for primary SS. The patients who developed neoplasia diagnosed according to the National Cancer Institute classification were retrospectively analyzed. RESULTSA total of 1,010 patients were included, 975 women, average age 57.21 years, 110 out of 909 patients (10%) presented cancer that was more prevalent in 55-year-old patients (p < 0,001). The diagnosis of cancer occurred after the diagnosis of SS in 10 out of 15 (66.7%) of the cases of lymphoma, 37 out of 68 (54.4%) other cancers and in 12 out of 16 (75.0%) of skin cancers. Regarding the subtypes of cancer, 21 (2.5%) patients had skin cancer, 15 (1.5%) had lymphoma, and 68 (6.7%) had other neoplasms. Basal cell carcinoma 13 (59%) was the most prevalent skin cancer, followed by melanoma 5 (0.6%). Lymphoma was the most prevalent cancer after skin cancer in our population, and non-Hodgkin MALT lymphoma 11 (73%) was the most prevalent with respect to lymphoma subtypes. Regarding other cancers, thyroid cancer 9 (0.9%) was the most prevalent, followed by ovarian cancer, 4 (0.4%) cases. Regarding the prognosis 18 out of 21 (90%) with skin cancer, 13 out of 15 (86.7%) with lymphoma and 51 out of 68 (81%) with other cancers progressed to cure, 4 (6.3%) patients had metastases, 4 (6.3%) relapsed and 4 (6.3%) died. The presence of cancer was associated with age (OR = 1.03), disease duration (OR = 1.01) and the presence of anti-Ro/SSa antibodies p < 0.008. CONCLUSIONSkin cancer is the most prevalent cancer as it is in Brazilian general population. Lymphoma was the most prevalent cancer after skin cancer in our population. Among other cancers, thyroid and ovarian cancer were the most prevalent, which differs from the Brazilian female population in which breast cancer is the most prevalent and thyroid cancer is the fifth in prevalence. Patients with SS have different kinds of cancer and its prevalence is superior and differs from the general population without SS.
BACKGROUNDTo analyze patients profile diagnosed with Vogt-Koyanagi-Harada syndrome (VKHS) in a joint outpatient clinic for rheumatology and ophthalmology at a tertiary hospital, as well as the proposed treatment and its effectiveness.
BACKGROUNDSystemic lupus erythematosus (SLE) is a chronic, multisystemic, immune-mediated disorder associated with a substantial hospitalization risk. The studies on frequency and causes of hospitalizations are conflicting. We aim to describe causes and rates of hospitalization for SLE patients in a tertiary reference hospital. METHODSThis cross-sectional retrospective study evaluated SLE patients aged 18-65 years and admitted to infirmaries from January 2014 to December 2020. Medical records were revised for demographic, clinical and laboratory characteristics, previous and ongoing treatments and the reason for admission. RESULTSWe included 452 patients. The mean age was 37 years, and 88% were females. Except for 7.5% newly diagnosed SLE, all patients were in use of immunosuppressive drugs (azathioprine, methotrexate or cyclophosphamide) and glucocorticoids up to 1 mg/kg/day of prednisone or equivalent. Flare (or active disease) of SLE was the most common cause of hospitalization (44%), followed by infection (24%) and treatment with intravenous drugs (16%). Approximately 3.5% of patients were admitted for gynecological or obstetric reasons, and 1.5% for treatment of manifestations related to antiphospholipid antibody syndrome. Other causes contributed for 10% of admissions. Flares were due to renal (14%), more than one organ or system (12%), central and peripheral nervous system (8%), hematologic (2.5%), pulmonary (2%), cardiac (1.5%), blood vessels (1%), serosa (1%), joint (0.9%) and skin (0.6%) involvement. CONCLUSIONFlare was the most common reason for hospital admission in SLE, which matches previously published studies. Kidneys were the most frequently affected organ, which is consistent with previous reports. Infection was the second most frequent cause of hospitalization, and may be related to the disease itself, associated comorbidities or immunosuppressive therapy. Manifestations of the disease were the main cause of hospitalizations in SLE. Infections presented as another important cause of need for hospital care, which can be at least in part attributed to immunosuppressive therapy.
BACKGROUNDSystemic lupus erythematosus (SLE) is a chronic disorder associated with a substantial hospitalization risk. Distinction between infection and flare in patients with SLE is a challenge in clinical practice. Hematimetric indices, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune inflammatory index (SII) (neutrophil × platelet / lymphocyte) are considered and used as biomarkers of immune system activation and response. We aimed to investigate the performance of these indices in SLE patients under two different conditions: during the course of systemic bacterial infection and after recovery.
BACKGROUNDThis work aimed to evaluate the use of immunobiological drugs in autoimmune anterior uveitis in patients referred by rheumatologists and ophthalmologists to an autoimmune ocular disease clinic.
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