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Digestive involvement in primary Sjögren's syndrome: analysis from the Sjögrenser registry


1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31

 

  1. Rheumatology Department, Hospital Universitario Doce de Octubre, Madrid, Spain. sheila.melchor@salud.madrid.org
  2. Unidad de Investigación de la SER, Madrid, Spain.
  3. Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
  4. Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
  5. Hospital Universitario Marqués de Valdecilla, Facultad de Medicina Universidad de Cantabria, Santander, Spain.
  6. Hospital Germans Trias i Pujol, Barcelona, Spain.
  7. Hospital Marina Baixa, Alicante, Spain.
  8. Hospital General Jerez de la Frontera, Cádiz, Spain.
  9. Hospital Virgen de la Salud, Toledo, Spain.
  10. Hospital Universitario Gregorio Marañón, Madrid, Spain.
  11. Hospital Universitario Carlos Haya, Málaga, Spain.
  12. Hospital Universitario de la Princesa, Madrid, Spain.
  13. Hospital Virgen de la Concha, Zamora, Spain.
  14. Hospital Universitario de Bellvitge, Barcelona, Spain.
  15. Hospital Universitario Parc-Taulí, Barcelona, Spain.
  16. Hospital Universitario Madrid Norte Sanchinarro, Madrid, Spain.
  17. Hospital Universitario Doctor Negrín, Las Palmas, Spain.
  18. Hospital Universitario Infanta Sofía, Madrid, Spain.
  19. Complejo Hospitalario de Pontevedra, Spain.
  20. Hospital Clínico Universitario San Cecilio, Granada, Spain.
  21. Hospital do Meixoeiro, Vigo, Spain.
  22. Hospital Universitario de Albacete, Spain.
  23. Hospital Universitario de León, Spain.
  24. Hospital General de L’Hospitalet, Barcelona, Spain.
  25. Hospital Universitario Miguel Servet, Zaragoza, Spain.
  26. Hospital Universitario Ramón y Cajal, Madrid, Spain.
  27. Hospital Universitario Santa Creu y Sant Pau, Barcelona, Spain.
  28. Hospital Universitario Príncipe de Asturias, Madrid, Spain.
  29. Hospital Universitario Marqués de Valdecilla, Facultad de Medicina Universidad de Cantabria, Santander, Spain.
  30. Hospital Universitario de Donostia, Guipúzcoa, Spain.
  31. Rheumatology Department, Hospital Universitario Doce de Octubre, Madrid, Spain.

on behalf of the Sjögrenser group, part of the Spanish Society of Rheumatology Systemic Autoimmune Diseases Study Group (EASSER)

CER13789
2020 Vol.38, N°4 ,Suppl.126
PI 0110, PF 0115
Clinical aspects

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PMID: 33025900 [PubMed]

Received: 08/07/2020
Accepted : 14/09/2020
In Press: 01/10/2020
Published: 22/10/2020

Abstract

OBJECTIVES:
Digestive involvement (DI) has been reported in 10-30% of primary Sjögren’s syndrome (pSS) patients, and few studies have systematically analysed the prevalence of DI in pSS patients. The aim of this study was to describe DI prevalence in pSS patients from the Sjögrenser Study, and to analyse its clinical associations.
METHODS:
All patients included in the Sjögrenser study, a Spanish multicentre randomised cohort, containing demographic, clinical and histologic data, have been analysed retrospectively. Patients were classified according to the presence of DI (oesophageal, gastric, intestinal, hepatic and pancreatic), and we have performed DI clinical associations, descriptive statistics, Student t or χ2 test, and uni and multivariate logistic regression.
RESULTS:
From 437 included patients, 95% were women, with a median age of 58 years, 71 (16.2%) presented DI: 21 (29.5%) chronic atrophic gastritis, 12 (16.9%) oesophageal motility dysfunction, 3 (4.2%) lymphocytic colitis, 18 (25.3%) primary biliary cholangitis, 15 (21.1%) autoimmune hepatitis, 7 (9.8%) pancreatic involvement and 5 (7%) coeliac disease. Half of them developed DI at the same time or after pSS diagnosis. Patients with DI were significantly older at pSS diagnosis (p=0.032), more frequently women (p=0.009), presented more autoimmune hypothyroidism and C3 hypocomplementaemia (p=0.040), and were treated more frequently with glucocorticoids, immunosuppressant and biologic therapies. Patients with pancreatic involvement presented more central nervous system and renal involvement, Raynaud’s phenomenon, lymphoma and C3/C4 hypocomplementaemia.
CONCLUSIONS:
DI is frequent in Sjögrenser patients, mainly in the form of autoimmune disorders, and seem to be associated with a more severe phenotype. Our results suggest that DI should be evaluated in pSS patients, especially those with more severe disease.

Rheumatology Article