A carregar...
Publicação
Caracterização da população de doentes com esclerose sistémica seguidos em consulta de Reumatologia no Hospital de Santa Maria
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| 736.33 KB | Adobe PDF |
Autores
Orientador(es)
Resumo(s)
A esclerose sistémica (ES) é uma doença do tecido conjuntivo, caracterizada por inflamação, fibrose e dano microvascular, com manifestações clínicas, imunológicas, progressão da doença e resposta à terapêutica muito heterogéneas.
Neste estudo realizou-se uma caracterização demográfica, clínica, imunológica e terapêutica da população de doentes com ES acompanhados em consulta de Reumatologia no CHULN. Realizou-se também uma análise descritiva dos dados clínicos de doentes com ES integrados na plataforma EUSTAR.
Foram incluídos doentes com ES difusa, ES limitada, ES sine scleroderma e ES pré-clínica, colhidos dados demográficos, clínicos, imunológicos e terapêuticos, a partir dos processos clínicos e registos da plataforma Reuma.pt. Realizou-se uma análise descritiva e comparou-se as formas difusa e limitada de ES, a partir dos testes Mann-Whitney e Qui-quadrado. Após recolha de consentimentos informados, integraram-se dados clínicos dos doentes com ES na plataforma EUSTAR, com consequente análise descritiva.
A maioria dos doentes era do sexo feminino (87,8%), 51,1% apresentavam ES limitada e 23,0% ES difusa. A maioria apresentava ANA (83,8%), 45,3% tinha anticorpos anticentrómero e 24,8% tinha anticorpos anti-topoisomerase I. Clinicamente, 89,2% apresentava FR, 43,9% tinha telangiectasias, 37,8% tinha úlceras digitais, 35,3% tinha artrite, 25,9% tinha envolvimento esofágico e 32,7% tinha envolvimento pulmonar, nomeadamente DIP (27,0%). Os fármacos mais frequentemente utilizados foram bloqueadores dos canais de cálcio (BCC), iloprost, metotrexato, glucocorticoides, pentoxifilina e aminoaftona. A ES limitada mostrou-se associada à presença de anticorpos anticentrómero, FR e telangiectasias. A ES difusa associa-se à presença de anticorpos anti-topoisomerase I, envolvimento esofágico, pulmonar e DIP. Na população EUSTAR, a prevalência de envolvimento cutâneo, envolvimento gastrointestinal, anticorpo anti-topoisomerase I e terapêutica com Iloprost, glucocorticoide, aminoaftona, BCC, bosentano e sildenafil foi superior comparativamente à população acompanhada em consulta no CHULN.
Verificou-se, na generalidade, que os doentes seguidos no CHULN apresentam características demográficas, clínicas e imunológicas que vão ao encontro do descrito por outros autores.
Systemic Sclerosis (SSc) is a connective tissue disease, characterized by inflammation, fibrosis and microvascular damage, with heterogeneous clinical and immunological manifestations, disease progression and response to therapy. In this study, we conducted a demographic, clinical, immunological, and therapeutic characterization of the patients with SSc followed up in the Rheumatology Clinic at CHULN and compared patients with diffuse SSc (dcSSc) and limited SSc (lcSSc). A descriptive analysis of the clinical data of patients with SSc integrated in the EUSTAR platform was also performed. Patients with dcSSc, lcSSc, SSine scleroderma and pre-clinical SSc were included, collecting demographic, clinical, immunological and therapeutic data, from the clinical files and records of the Reuma.pt platform. Descriptive analysis was performed, dcSSc and lcSSc were compared, using Mann-Whitney and Chi-square tests. After collecting informed consent, clinical data from patients with SSc were integrated into the EUSTAR platform, with subsequent descriptive analysis. Most patients were female (87.8%), 51.1% had lcSSc and 23.0% had dcSSc. Most had ANA (83.8%), 45.3% had anticentromere antibodies and 24.8% had anti-topoisomerase I antibodies. Clinically, 89.2% had RP, 43.9% had telangiectasias, 37.8% had digital ulcers, 35.3% had arthritis, 25.9% had esophageal involvement and 32.7% had lung involvement, namely ILD (27.0%). The most frequent drugs were calcium channel blockers (CCB), iloprost, methotrexate, systemic corticosteroids, pentoxifylline and aminaphtone. LcSSc was associated with the presence of anticentromere antibodies, RP and telangiectasia. DcSSc was associated with the presence of anti-topoisomerase I antibodies, esophageal and pulmonary involvement. In the EUSTAR population, the prevalence of cutaneous involvement, gastrointestinal involvement, anti-topoisomerase I antibody and treatment with iloprost, glucocorticoid, aminoaphthone, CCB, bosentan and sildenafil was higher compared to the population followed at CHULN. It was found, generally, that the patients followed at CHULN have demographic, clinical and immunological characteristics that are in line with what has been described by other authors.
Systemic Sclerosis (SSc) is a connective tissue disease, characterized by inflammation, fibrosis and microvascular damage, with heterogeneous clinical and immunological manifestations, disease progression and response to therapy. In this study, we conducted a demographic, clinical, immunological, and therapeutic characterization of the patients with SSc followed up in the Rheumatology Clinic at CHULN and compared patients with diffuse SSc (dcSSc) and limited SSc (lcSSc). A descriptive analysis of the clinical data of patients with SSc integrated in the EUSTAR platform was also performed. Patients with dcSSc, lcSSc, SSine scleroderma and pre-clinical SSc were included, collecting demographic, clinical, immunological and therapeutic data, from the clinical files and records of the Reuma.pt platform. Descriptive analysis was performed, dcSSc and lcSSc were compared, using Mann-Whitney and Chi-square tests. After collecting informed consent, clinical data from patients with SSc were integrated into the EUSTAR platform, with subsequent descriptive analysis. Most patients were female (87.8%), 51.1% had lcSSc and 23.0% had dcSSc. Most had ANA (83.8%), 45.3% had anticentromere antibodies and 24.8% had anti-topoisomerase I antibodies. Clinically, 89.2% had RP, 43.9% had telangiectasias, 37.8% had digital ulcers, 35.3% had arthritis, 25.9% had esophageal involvement and 32.7% had lung involvement, namely ILD (27.0%). The most frequent drugs were calcium channel blockers (CCB), iloprost, methotrexate, systemic corticosteroids, pentoxifylline and aminaphtone. LcSSc was associated with the presence of anticentromere antibodies, RP and telangiectasia. DcSSc was associated with the presence of anti-topoisomerase I antibodies, esophageal and pulmonary involvement. In the EUSTAR population, the prevalence of cutaneous involvement, gastrointestinal involvement, anti-topoisomerase I antibody and treatment with iloprost, glucocorticoid, aminoaphthone, CCB, bosentan and sildenafil was higher compared to the population followed at CHULN. It was found, generally, that the patients followed at CHULN have demographic, clinical and immunological characteristics that are in line with what has been described by other authors.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022
Palavras-chave
Esclerose sistémica Demografia Manifestações clínicas Manifestações imunológicas Reumatologia