Factors associated with abnormal Pap results in systemic lupus erythematosus

Bernatsky, Sasha; Ramsey‐Goldman, Rosalind; Gordon, Caroline; Joseph, Lawrence; Boivin, Jean François; Rajan, Raghu; Allen, Arthur C.; Moore, Andrew D.; Leung, Moon Ho; Clarke, Ann E.

doi:10.1093/rheumatology/keh331

Cited by 60 publications

(55 citation statements)

References 21 publications

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“…Moreover, Bertansky et al found an increase in abnormal cervical cytology in the lupus group vs. controls (P>0.0008). Furthermore, the abnormal cytopathology was accounted for by an excess of HGSIL and cancer (OR = 3.46; P >0.0003) (16,17) .…”

Section: Discussion:-mentioning

confidence: 97%

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Abnormal Pap Tests in Systemic Lupus Erythematosis: A Cytopathological and Human Papillomavirus Testing Study.

Girbash¹,

Atta²,

Fahmy³

et al. 2016

IJAR

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Objectives: the frequency of cervical squamous intra-epithelial lesions (SIL) in women with systemic lupus erythematosus (SLE), and the association between clinical parameters, use of immunosuppressant agents, human papillomavirus (HPV) infection, colposcopy, and development of SIL in SLE.Methods: A retrospective case control study conducted in 150 women constituted the study group with confirmed diagnosis of SLE. The enrolled patients divided into study group (no.28) with abnormal pap smears and reference group (no.122) with normal pap smears. All patients subjected to clinical evaluation, colposcopy, directed biopsies, and HPV-ISH testing. All participants reassessed every 6 months for 2 years.Results: mean patient age with abnormal pap smears was 44.8(P = 0.74) years with mean SLE disease duration was 9.3±7.1 years. There was past history of cervical lesions where it was positive in 89.3% (P = 0.001). SLE patients with abnormal pap smears showed significant difference regarding nephritis (P = 0.001) and high titers of Anti-double stranded DNA (P = 0.001) and Antiphospholipid antibodies (P = 0.012). SLEDAI, SDI, and immunosuppressant agent usage found significantly different among patients with abnormal pap smears. HPV Infection found significantly important (P = 0.001) when the infection was high-risk HPV, multiple HPV, or persistent HPV infection among patients with abnormal pap smears. On comparison with cytology, colposcopy, HPV-ISH results, the best sensitivity was with the use of HPV-ISH (90%) then with colposcopy (75%). In addition, the best specificity was with the use of colposcopy (99%). The highest positive predictive value was with colposcopy (94%) and the highest negative predictive value was with HPV-ISH assay (98%). Conclusion:Patients with SLE had higher risk for HPV infection and cervical dysplasia than the general population. Thus, gynecological visits at shorter intervals (3-6 months) recommended for those patients. The use of colposcopy is useful tool in areas where the screening of HPV is not available.

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Section: Discussion:-mentioning

confidence: 97%

“…One study showed an increased incidence of cervical cancer in SLE and other studies have noted a high risk of abnormal Pap tests in women with SLE (4) .…”

Section: Introduction:-mentioning

confidence: 98%

Abnormal Pap Tests in Systemic Lupus Erythematosis: A Cytopathological and Human Papillomavirus Testing Study.

Girbash¹,

Atta²,

Fahmy³

et al. 2016

IJAR

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“…Estudios observacionales no han encontrado asociación entre el uso de ACO en LES y el desarrollo de enfermedad vascular periférica (33), nefritis lúpica o cáncer de mama (16), pero sí una mayor frecuencia de Papanicolaou anormal (34).…”

Section: ) (26)unclassified

Anticoncepción hormonal en mujeres jóvenes con enfermedades reumatológicas

et al. 2014

Rev. chil. obstet. ginecol.

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RESUMENAntecedentes: Las enfermedades reumatológicas (ER) se presentan con mayor frecuencia en mujeres en edad fértil. Es durante este período que muchas mujeres consultan por trastornos de los flujos rojos, dismenorrea y prevención del embarazo. Objetivo: Realizar una puesta al día del uso de anticoncepción hormonal (AH) en mujeres jóvenes con ER, especialmente en las portadoras de lupus eritematoso sistémi-co (LES) y artritis reumatoide (AR). Método: Se revisó la literatura en Pubmed para los términos AH en ER, con especial énfasis en guías clínicas y ensayos clínicos aleatorizados. Resultados: El uso de AH en pacientes con LES inactivo o con actividad leve no ha mostrado un empeoramiento de la enfermedad. Tampoco existe evidencia categórica que demuestre un mayor riesgo trombótico en aquellas con anticuerpos antifosfolípidos negativos, para las cuales se recomienda el uso de cualquier tipo de AH. En pacientes con AR no se ha demostrado asociación del uso de AH y aumento de la actividad de la enfermedad. Además la interacción farmacológica entre AH y medicamentos reumatológicos es mínima. Existe escasa evidencia del uso de AH en mujeres menores de 18 años con ER. Conclusión: Basado en la evidencia disponible las pacientes con ER con anticuerpos antifosfolípidos negativos podrán utilizar AH según los criterios de la OMS, lo que abre las puertas a mayores alternativas terapéuticas y prevención de embarazo para estas adolescentes y mujeres jóvenes con ER.PALABRAS CLAVE: Anticoncepción, lupus eritematoso sistémico, artritis reumatoide, enfermedades reumatológicas, trombosis SUMMARYBackground: Rheumatologic diseases (RD) are most common in women of childbearing age. It is during this period that many women consult for menstrual disorders, dysmenorrhea and pregnancy prevention. Objective: To update the use of hormonal contraception (HC) in young women with RD. Method: Literature was reviewed in PubMed for HC and RD terms, with special emphasis on clinical guidelines and randomized clinical trials. Results: The use of HC in patients with inactive or mild activity systemic lupus erythematosus has not shown a worsening of the disease. Also, there is no evidence demonstrating greater thrombotic risk in those with negative antiphospholipid antibodies, for which the use of any type of HC is recommended. In patients with rheumatoid arthritis an association between use of HC and increases disease activity has not been demonstrated. In addition, there is minimal drug interaction between HC and rheumatologic drugs.There is little evidence of the use of HC in women less than 18 years with RD. Conclusion: Based on the available evidence the patients with RD and negative antiphospholipid antibodies could use HC according

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“…Entre elas, encontram-se: (a) anormalidades intrínsecas do sistema imunológico, decorrentes da própria doença, prejudicando a vigilância antitumoral; (b) presença de doenças associadas ao LES como a síndrome de Sjögren; (c) fatores geográficos, étnicos e raciais comuns a neoplasias e ao LES; (d) medicações utilizadas no tratamento do LES como azatioprina, metotrexato e ciclofosfamida; (e) interações entre as medicações e exposições virais (1,(6)(7)(8)(9) . Neoplasias de colo uterino incidem em 20/100.000 mulheres nas Regiões Sul e Sudeste do Brasil (10) .…”

Section: Introductionunclassified

“…Neoplasias de colo uterino incidem em 20/100.000 mulheres nas Regiões Sul e Sudeste do Brasil (10) . Lesões malignas (e pré-malignas) de cérvix uterina fazem parte dos tumores descritos como sendo mais prevalentes no LES (6,8,9) . Esse aspecto pretende ser explorado no presente estudo que tem por objetivo estabelecer a freqüência de alterações no esfregaço citopatológico (Papanicolaou) em uma população local de pacientes com LES e verificar se tal aumento está associado ao uso de medicações, tempo de doença e perfil de auto-anticorpos apresentado.…”

Section: Introductionunclassified

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

Barros¹,

Matschinske²,

Silva³

et al. 2007

Rev. Bras. Reumatol.

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Factors associated with abnormal Pap results in systemic lupus erythematosus

Abstract: A history of STDs and use of OCs were associated with abnormal Pap reports in this SLE sample. Immunosuppressive exposure may confer further risk to women with SLE.

Cited by 60 publications

References 21 publications

Abnormal Pap Tests in Systemic Lupus Erythematosis: A Cytopathological and Human Papillomavirus Testing Study.

Abnormal Pap Tests in Systemic Lupus Erythematosis: A Cytopathological and Human Papillomavirus Testing Study.

Anticoncepción hormonal en mujeres jóvenes con enfermedades reumatológicas

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

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