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Vol. 4. Núm. S1.
Monográfico: Enfermedades sistémicas autoinmunitarias
Páginas 22-27 (marzo 2008)
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Vol. 4. Núm. S1.
Monográfico: Enfermedades sistémicas autoinmunitarias
Páginas 22-27 (marzo 2008)
Enfermedades sistémicas autoinmunitarias
Acceso a texto completo
Síndrome de Sjögren
Sjögren's Syndrome
Visitas
100730
Hèctor Corominas
Autor para correspondencia
vancor@yahoo.com

Correspondencia: Dr. H. Corominas. Unitat de Reumatologia. Hospital Dos de Maig. Dos de Maig, 301. 08028 Barcelona. España.
, Ramon Fíguls, Manel Riera
Unitat de Reumatologia. Hospital Dos de Maig. Barcelona. España
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Resumen
Bibliografía
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El síndrome de Sjögren es una enfermedad sistémica autoinmunitaria que se caracteriza por queratoconjuntivitis seca, xerostomía y un amplio espectro de signos y síntomas que se traduce en una enfermedad muy heterogénea. La forma leve con afección de mucosas es la más frecuente, pero existen patrones más severos y activos, que se manifiestan por afección extraglandular, con peor pronóstico. El espectro clínico incluye afección de mucosas, fenómeno de Raynaud, parotidomegalia o artritis, pero puede agravarse por afección neurológica, pulmonar o renal. El tratamiento inicial incluye el tratamiento tópico con lágrimas artificiales, pomadas nocturnas, hasta fármacos sialogogos para la afección glandular importante, mientras que la afección sistémica grave precisa de tratamiento immunosupresor. Recientemente han aportado datos relevantes sobre la utilización de fármacos biológicos en el tratamiento de casos severos y pertinaces.

Palabras clave:
Síndrome de Sjögren
Queratoconjuntivitis seca
Xerostomía

Sjögren's syndrome is a systemic autoimmune disease that is characterized by the presence of keratoconjunctivitis sicca, xerostomy and a large spectrum of signs and symptoms that translate into a very heterogeneous disease. The mild form that affects mucosal tissues is the most frequent, but there are more severe and active patterns, manifested by the presence of extraglandular affection with a worse prognosis. The clinical spectrum includes anything from mucosal alterations, Raynaud's phenomenon, parotid enlargement or arthritis, but can be aggravated by the presence of neurological, lung or renal affection. Initial therapy includes topical treatment with artificial tears, nocturnal cream and drugs that stimulate secretion for important glandular affection, while severe systemic affection merits immunosuppressant therapy. There has been recent evidence that biologic therapy is useful for the treatment of severe and resistant cases.

Key words:
Sjögren's syndrome
Keratoconjunctivitis sicca
Xerostomy
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Bibliografía
[1.]
R.I. Fox, M. Stern, P. Michelson.
Update in Sjogren syndrome.
Curr Opin Rheumatol, 12 (2000), pp. 391-398
[2.]
U.G. Dafni, A.G. Tzioufas, P. Staikos, F.N. Skopouli, H.M. Moutsopoulos.
Prevalence of Sjogren's syndrome in a closed rural community.
Ann Rheum Dis, 56 (1997), pp. 521-525
[3.]
E. Thomas, E.M. Hay, A. Hajeer, A.J. Silman.
Sjogren's syndrome: a community- based study of prevalence and impact.
Br J Rheumatol, 37 (1998), pp. 1069-1076
[4.]
Y. Alamanos, N. Tsifetaki, P.V. Voulgari, A.I. Venetsanopoulou, C. Siozos, A.A. Drosos.
Epidemiology of primary Sjogren's syndrome in north-west Greece, 1982-2003.
Rheumatology (Oxford), 45 (2006), pp. 187-191
[5.]
J. Font, M. Garcia-Carrasco, M. Ramos-Casals, A.I. Aldea, R. Cervera, M. Ingelmo, et al.
The role of interleukin-10 promoter polymorphisms in the clinical expression of primary Sjogren's syndrome.
Rheumatology (Oxford), 41 (2002), pp. 1025-1030
[6.]
A. Triantafyllopoulou, H.M. Moutsopoulos.
Autoimmunity and Coxsackievirus infection in primary Sjogren's syndrome.
Ann N Y Acad Sci, 1050 (2005), pp. 389-396
[7.]
A. Triantafyllopoulou, N. Tapinos, H.M. Moutsopoulos.
Evidence for Coxsackievirus infection in primary Sjogren's syndrome.
Arthritis Rheum, 50 (2004), pp. 2897-2902
[8.]
A. Hansen, P.E. Lipsky, T. Dorner.
Immunopathogenesis of primary Sjogren's syndrome: implications for disease management and therapy.
Curr Opin Rheumatol, 17 (2005), pp. 558-565
[9.]
A. Hansen, K. Reiter, T. Ziprian, A. Jacobi, A. Hoffmann, M. Gosemann, et al.
Dysregulation of chemokine receptor expression and function by B cells of patients with primary Sjogren's syndrome.
Arthritis Rheum, 52 (2005), pp. 2109-2119
[10.]
M. Ramos-Casals, J. Font.
Primary Sjogren's syndrome: current and emergent aetiopathogenic concepts.
Rheumatology (Oxford), 44 (2005), pp. 1354-1367
[11.]
E.A. Boutsi, S. Paikos, U.G. Dafni, H.M. Moutsopoulos, F.N. Skopouli.
Dental and periodontal status of Sjogren's syndrome.
J Clin Periodontol, 27 (2000), pp. 231-235
[12.]
M. Garcia-Carrasco, M. Ramos-Casals, J. Rosas, L. Pallarés, J. Calvo-Alen, R. Cervera, et al.
Primary Sjogren syndrome: clinical and immunologic disease patterns in a cohort of 400 patients.
Medicine (Baltimore), 81 (2002), pp. 270-280
[13.]
C.P. Mavragani, U.G. Dafni, A.G. Tzioufas, H.M. Moutsopoulos.
Pregnancy outcome and anti-Ro/SSA in autoimmune diseases: a retrospective cohort study.
Br J Rheumatol, 37 (1998), pp. 740-745
[14.]
M. Ramos-Casals, P. Brito-Zeron, J. Font.
The overlap of Sjogren's syndrome with other systemic autoimmune diseases.
Semin Arthritis Rheum, 36 (2007), pp. 246-255
[15.]
C. Diaz-Lopez, C. Geli, H. Corominas, N. Malat, C. Diaz-Torner, J.M. Llobet, et al.
Are there clinical or serological differences between male and female patients with primary Sjogren's syndrome?.
J Rheumatol, 31 (2004), pp. 1352-1355
[16.]
A.A. Drosos, E.K. Tsiakou, N. Tsifetaki, E.N. Politi, A. Siamopoulou-Mavridou.
Subgroups of primary Sjogren's syndrome. Sjogren's syndrome in male and paediatric Greek patients.
Ann Rheum Dis, 56 (1997), pp. 333-335
[17.]
P. Brito-Zeron, M. Ramos-Casals, A. Bove, J. Sentis, J. Font.
Predicting adverse outcomes in primary Sjogren's syndrome: identification of prognostic factors.
Rheumatology (Oxford), 46 (2007), pp. 1359-1362
[18.]
C. Vitali, S. Bombardieri, H.M. Moutsopoulos, G. Balestrieri, W. Bencivelli, R.M. Bernstein, et al.
Preliminary criteria for the classification of Sjogren's syndrome. Results of a prospective concerted action supported by the European Community.
Arthritis Rheum, 36 (1993), pp. 340-347
[19.]
C. Vitali, S. Bombardieri, R. Jonsson, H.M. Moutsopoulos, E.L. Alexander, S.E. Carsons, et al.
Classification criteria for Sjogren's syndrome: a revised version of the European criteria proposed by the American-European Consensus Group.
Ann Rheum Dis, 61 (2002), pp. 554-558
[20.]
A. Kessel, E. Toubi, M. Rozenbaum, D. Zisman, E. Sabo, I. Rosner.
Sjogren's syndrome in the community: can serology replace salivary gland biopsy?.
Rheumatol Int, 26 (2006), pp. 337-339
[21.]
P. Morbini, A. Manzo, R. Caporali, O. Epis, C. Villa, C. Tinelli, et al.
Multilevel examination of minor salivary gland biopsy for Sjogren's syndrome significantly improves diagnostic performance of AECG classification criteria.
Arthritis Res Ther, 7 (2005), pp. R343-R348
[22.]
C.P. Mavragani, N.M. Moutsopoulos, H.M. Moutsopoulos.
The management of Sjogren's syndrome.
Nat Clin Pract Rheumatol, 2 (2006), pp. 252-261
[23.]
P. Brito-Zeron, M. Ramos-Casals, N. Nardi, J. Font.
Results of the treatment with oral pilocarpine in 100 patients with primary Sjogren's syndrome.
Med Clin (Barc), 126 (2006), pp. 637
[24.]
P.C. Fox, P.F. Van der Ven, B.J. Baum, I.D. Mandel.
Pilocarpine for the treatment of xerostomia associated with salivary gland dysfunction.
Oral Surg Oral Med Oral Pathol, 61 (1986), pp. 243-248
[25.]
N. Tsifetaki, G. Kitsos, C.A. Paschides, Y. Alamanos, V. Eftaxias, P.V. Voulgari.
Oral pilocarpine for the treatment of ocular symptoms in patients with Sjogren's syndrome: a randomised 12 week controlled study.
Ann Rheum Dis, 62 (2003), pp. 1204-1207
[26.]
N.M. Moutsopoulos, H.M. Moutsopoulos.
Therapy of Sjogren's syndrome.
Springer Semin Immunopathol, 23 (2001), pp. 131-145
[27.]
M. Ramos-Casals, A.G. Tzioufas, J. Font.
Sjogren syndrome. New therapeutic approaches.
Med Clin (Barc), 124 (2005), pp. 111-115
[28.]
K. Ahmadi-Simab, P. Lamprecht, B. Nolle, M. Ai, W.L. Gross.
Successful treatment of refractory anterior scleritis in primary Sjogren's syndrome with rituximab.
Ann Rheum Dis, 64 (2005), pp. 1087-1088
[29.]
V. Devauchelle-Pensec, Y. Pennec, J. Morvan, J.O. Pers, C. Daridon, S. Jousse- Joulin.
Improvement of Sjogren's syndrome after two infusions of rituximab (anti-CD20).
Arthritis Rheum, 57 (2007), pp. 310-317
[30.]
J. Pijpe, G.W. Van Imhoff, F.K. Spijkervet, J.L. Roodenburg, G.J. Wolbink, K. Mansour.
Rituximab treatment in patients with primary Sjogren's syndrome: an open-label phase II study.
Arthritis Rheum, 52 (2005), pp. 2740-2750
[31.]
T. Ring, M. Kallenbach, J. Praetorius, S. Nielsen, B. Melgaard.
Successful treatment of a patient with primary Sjogren's syndrome with Rituximab.
Clin Rheumatol, 25 (2006), pp. 891-894
[32.]
Z. Touma, J. Sayad, T. Arayssi.
Successful treatment of Sjogren's syndrome with rituximab.
Scand J Rheumatol, 35 (2006), pp. 323-325
[33.]
J. Pijpe, G.W. Van Imhoff, A. Vissink, J.E. Van der Wal, P.M. Kluin, F.K. Spijkervet, et al.
Changes in salivary gland immunohistology and function after rituximab monotherapy in a patient with Sjogren's syndrome and associated MALT lymphoma.
Ann Rheum Dis, 64 (2005), pp. 958-960
[34.]
M. Ramos-Casals, P. Brito-Zeron.
Emerging biological therapies in primary Sjogren's syndrome.
Rheumatology (Oxford), 46 (2007), pp. 1389-1396
[35.]
S.D. Steinfeld, L. Tant, G.R. Burmester, N.K. Teoh, W.A. Wegener, D.M. Goldenberg, et al.
Epratuzumab (humanised anti-CD22 antibody) in primary Sjogren's syndrome: an open-label phase I/II study.
Arthritis Res Ther, 8 (2006), pp. 129
[36.]
W.G. Halpern, P. Lappin, T. Zanardi, W. Cai, M. Corcoran, J. Zhong, et al.
Chronic administration of belimumab, a BLyS antagonist, decreases tissue and peripheral blood B-lymphocyte populations in cynomolgus monkeys: pharmacokinetic, pharmacodynamic, and toxicologic effects.
Toxicol Sci, 91 (2006), pp. 586-599
Copyright © 2008. Elsevier España S.L. Barcelona
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