Prevalência de alterações no exame citológico do colo do útero em pacientes com lúpus eritematoso sistêmico

Barros, Bernardo Rodi; Matschinske, Roberta; Silva, Marilia Barreto; Skare, Thelma Larocca

doi:10.1590/s0482-50042007000500006

Cited by 5 publications

(1 citation statement)

References 6 publications

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“…These alterations, however, did not correlate with the time of disease, use of ISA, presence of anti-Ro, anti-La or anti-DNA. 20 The group with menstrual alterations in our series, when segmented, shows that 26.4% of the cases occurred in patients receiving some type of corticoid. The mechanism of action of corticoids influences several organs and functions of the human body.…”

Section: Discussionmentioning

confidence: 58%

Alterações menstruais em pacientes com lúpus eritematoso sistêmico sob uso de imunossupressores

Nonato¹,

Barbosa²,

Rodrigues³

et al. 2010

Rev. Bras. Reumatol.

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Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease that affects fertile-age women and of which treatment includes immunosuppressive agents that can affect the gonads. Objective: To evaluate the frequency of menstrual alterations in lupus patient treated with immunosuppressive agents (ISA). Patients and Methods: A total of 87 patients, aged < 40 years, were studied. The patients were followed by outpatient management and the treatment used was verified. Only organic causes of menstrual alterations were excluded from the study. The menstrual alterations were correlated with the type and time of use of different ISA. Results: Age varied from 14 to 38 years, with a mean age of 28.01 ± 5.81 years; the mean age at menarche was 13.12 ± 1.77 years and the diagnosis of SLE was at 21.40 ± 5.75 years. Corticoids were used as single therapy by 63.2% of them, for a mean time of 6.11 ± 5.14 years and the use of other immunosuppressive agents occurred with a mean time of 5.60 ± 3.59 years. Menstrual alterations occurred in 37.9% and amenorrhea in 11.5%. There was an association between menstrual alterations with the use of ISA (P = 0.034). Conclusion: The frequency of menstrual alterations was higher than that found in the general population, similar to what was observed in other publications on lupus treatment. The higher frequency of menstrual alterations in these patients was significantly associated with the use of ISA. The results justify caution when prescribing these medications, research indication and the use of techniques for ovarian preservation means.

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Section: Discussionmentioning

confidence: 58%

Alterações menstruais em pacientes com lúpus eritematoso sistêmico sob uso de imunossupressores

Nonato¹,

Barbosa²,

Rodrigues³

et al. 2010

Rev. Bras. Reumatol.

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Prevalence of cervical human papillomavirus infection in women with systemic lupus erythematosus

et al. 2012

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Genital infection by human papillomavirus (HPV) tends to occur more frequently in patients with conditions associated with immune suppression. Systemic lupus erythematosus (SLE) is an immunological disorder characterized by generalized inflammation and a number of clinical manifestations and circulating autoantibodies. The aim of the present study was to determine the prevalence of genital HPV infection among female SLE patients. Women diagnosed with SLE based on American College of Rheumatology classification criteria followed at rheumatology outpatient clinic of the Escola Bahiana de Medicina e Saude Publica, Salvador, Brazil, were included in the study. As a comparison group, clinically healthy women who were attending the gynecology outpatient clinic for routine examination at the same institution were recruited. Testing for cervical HPV infection was performed using the nested polymerase chain reaction technique. Eighty-eight female SLE patients (mean age, 41.4 ± 11.6 years) and seventy healthy female subjects (control group) were studied. The prevalence of HPV infection was 80.7 % (71/88) in the SLE group and 35.7 % (25/70) in the control group (p < 0.0001). After adjustment of the variables (early sexual activity, number of partners and obstetric history), the odds ratio (OR) for genital HPV infection in women with SLE was 7.2 (95 % CI, 2.9 to 17.8; p = 0.0001). The use of immunosuppressive drugs was not associated with a higher prevalence of HPV infection. This study demonstrated that SLE patients have a higher prevalence of genital HPV infection, even when exposed to less potential risk factors for the virus.

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Systemic lupus erythematosus, human papillomavirus infection, cervical pre-malignant and malignant lesions: a systematic review

et al. 2010

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The purpose of this study was to review and evaluate systematically the scientific evidence on the relationship between systemic lupus erythematosus (SLE), human papillomavirus (HPV) infection, pre-cancerous cervical abnormalities, and cervical cancer. Establishing strict inclusion and exclusion criteria, we performed an extensive search for studies in MEDLINE and BIREME databases to assess the studies that evaluated the frequency of HPV infection, pre-cancerous cervical abnormalities, and cervical cancer in women with SLE. Secondary references were additionally obtained from the included articles. Thirty-three articles met the criteria previously established. Fifteen out of 18 studies that performed cytological analysis showed a higher frequency of squamous intraepithelial lesions in SLE patients compared with normal women. Moreover, three studies found a higher frequency of high-grade squamous intraepithelial lesions. Additionally, it was observed that women with SLE had a higher frequency of HPV infection, confirmed by molecular biology techniques. Curiously, despite the above findings, no increased frequency of cervical cancer was observed in the majority of the studies which addressed this issue. Five studies observed a relationship between cervical abnormalities and previous use of immunosuppressive drugs. This review suggests that SLE patients seem not to be at increased risk for developing cervical cancer; however, they should be considered at higher risk for HPV infection and cervical dysplasia than the general population. Thus, gynecological visits at shorter intervals seem to be a reasonable approach for those patients.

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Prevalência de alterações no exame citológico do colo do útero em pacientes com lúpus eritematoso sistêmico

Cited by 5 publications

References 6 publications

Alterações menstruais em pacientes com lúpus eritematoso sistêmico sob uso de imunossupressores

Alterações menstruais em pacientes com lúpus eritematoso sistêmico sob uso de imunossupressores

Prevalence of cervical human papillomavirus infection in women with systemic lupus erythematosus

Systemic lupus erythematosus, human papillomavirus infection, cervical pre-malignant and malignant lesions: a systematic review

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