Abdominal symptoms during Sjogren's syndrome: a pilot study.
Abdominal symptoms
ESSDAI
ESSPRI
Gastroparesis
Quality of life
Sjögren’s syndrome
Journal
Advances in rheumatology (London, England)
ISSN: 2523-3106
Titre abrégé: Adv Rheumatol
Pays: England
ID NLM: 101734172
Informations de publication
Date de publication:
19 01 2021
19 01 2021
Historique:
received:
13
09
2020
accepted:
02
01
2021
entrez:
20
1
2021
pubmed:
21
1
2021
medline:
3
11
2021
Statut:
epublish
Résumé
Abdominal symptoms in patients with primary Sjögren syndrome (pSS) are poorly documented. The objective of the study was to describe the abdominal symptoms of patients with pSS and to assess their association with characteristics of the disease. One hundred and fifty patients with pSS were evaluated using a composite global symptom score for abdominal symptoms and their severity. Data concerning the clinical and biological characteristics of pSS and abdominal disorders were also collected. Of the patients with pSS, 95% suffered from abdominal symptoms (median global symptom score 7.5 ± 5.5 points out of 30). More than half of the patients experienced abdominal tension (68%), upper abdominal pain (54%), abdominal discomfort (58%) and/or constipation (54%). Regarding the pSS activity, in relation to European League Against Rheumatism (EULAR) Sjögren syndrome disease activity index score items, general and central nervous system involvement wereassociated with a high global symptom score. The EULAR Sjogren Syndrome Patient Reported Index (ESSPRI) symptom score was positively correlated with the global symptom score (p < 0.01). Multivariate analysis showed a significant association between a high global symptom score and SSA seronegativity, gastroparesis, and ESSPRI score (p < 0.01 for each). The majority of patients with pSS suffered abdominal symptoms. There is currently no therapeutic recommendation because of the lack of information on the underlying pathophysiological mechanisms. NCT03157011 . Date of registration: July 17, 2017.
Sections du résumé
BACKGROUND
Abdominal symptoms in patients with primary Sjögren syndrome (pSS) are poorly documented. The objective of the study was to describe the abdominal symptoms of patients with pSS and to assess their association with characteristics of the disease.
METHODS
One hundred and fifty patients with pSS were evaluated using a composite global symptom score for abdominal symptoms and their severity. Data concerning the clinical and biological characteristics of pSS and abdominal disorders were also collected.
RESULTS
Of the patients with pSS, 95% suffered from abdominal symptoms (median global symptom score 7.5 ± 5.5 points out of 30). More than half of the patients experienced abdominal tension (68%), upper abdominal pain (54%), abdominal discomfort (58%) and/or constipation (54%). Regarding the pSS activity, in relation to European League Against Rheumatism (EULAR) Sjögren syndrome disease activity index score items, general and central nervous system involvement wereassociated with a high global symptom score. The EULAR Sjogren Syndrome Patient Reported Index (ESSPRI) symptom score was positively correlated with the global symptom score (p < 0.01). Multivariate analysis showed a significant association between a high global symptom score and SSA seronegativity, gastroparesis, and ESSPRI score (p < 0.01 for each).
CONCLUSIONS
The majority of patients with pSS suffered abdominal symptoms. There is currently no therapeutic recommendation because of the lack of information on the underlying pathophysiological mechanisms.
TRIAL REGISTRATION
NCT03157011 . Date of registration: July 17, 2017.
Identifiants
pubmed: 33468262
doi: 10.1186/s42358-021-00164-w
pii: 10.1186/s42358-021-00164-w
doi:
Banques de données
ClinicalTrials.gov
['NCT03157011']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
5Références
Qin B, Wang J, Yang Z, Yang M, Ma N, Huang F, et al. Epidemiology of primary Sjögren’s syndrome: a systematic review and meta-analysis. Ann Rheum Dis. 2015;74:1983–9.
doi: 10.1136/annrheumdis-2014-205375
Ebert EC. Gastrointestinal and hepatic manifestations of Sjogren syndrome. J Clin Gastroenterol. 2012;46:25–30.
doi: 10.1097/MCG.0b013e3182329d9c
Shiboski CH, Shiboski SC, Seror R, Criswell LA, Labetoulle M, Lietman TM, et al. 2016 American College of Rheumatology/European league against rheumatism classification criteria for primary Sjögren’s syndrome: A consensus and data-driven methodology involving three international patient cohorts. Arthritis Rheum. 2017;69:35–45.
doi: 10.1002/art.39859
Seror R, Theander E, Brun JG, Ramos-Casals M, Valim V, Dörner T, et al. Validation of EULAR primary Sjögren’s syndrome disease activity (ESSDAI) and patient indexes (ESSPRI). Ann Rheum Dis. 2015;74:859–66.
doi: 10.1136/annrheumdis-2013-204615
Marie I, Gourcerol G, Leroi AM, Ménard JF, Levesque H, Ducrotté P, et al. Delayed gastric emptying determined using the 13C-octanoic acid breath test in patients with systemic sclerosis. Arthritis Rheum. 2012;64:2346–55.
doi: 10.1002/art.34374
Latella G, Pimpo M, Sottili S, Zippi M, Viscido A, Chiaramonte M, et al. Rifaximin improves symptoms of acquired uncomplicated diverticular disease of the colon. Int J Color Dis. 2003;18:55–62.
doi: 10.1007/s00384-002-0396-5
Di Mario F, Aragona G, Leandro G, Comparato G, Fanigliulo L, Cavallaro LG, et al. Efficacy of mesalazine in the treatment of symptomatic diverticular disease. Dig Dis Sci. 2005;50:581–6.
doi: 10.1007/s10620-005-2478-z
Di Mario F, Stefani N, Dal Bò N, Rugge M, Pilotto A, Cavestro GM, et al. Natural course of functional dyspepsia after helicobacter pylori eradication: a seven-year survey. Dig Dis Sci. 2005;50:2286–9.
doi: 10.1007/s10620-005-3049-z
Marie I, Leroi AM, Gourcerol G, Levesque H, Menard JF, Ducrotte P. Lactose malabsorption in systemic sclerosis. Aliment Pharmacol Ther. 2016;44:1123–33.
doi: 10.1111/apt.13810
Gemignani L, Savarino V, Ghio M, Parodi A, Zentilin P, de Bortoli N, et al. Lactulose breath test to assess oro-cecal transit delay and estimate esophageal dysmotility in scleroderma patients. Semin Arthritis Rheum. 2013;42:522–9.
doi: 10.1016/j.semarthrit.2012.09.004
Marie I, Ducrotté P, Denis P, Menard JF, Levesque H. Small intestinal bacterial overgrowth in systemic sclerosis. Rheumatology. 2009;48:1314–9.
doi: 10.1093/rheumatology/kep226
Parodi A, Sessarego M, Greco A, Bazzica M, Filaci G, Setti M, Savarino E, Indiveri F, Savarino V, Ghio M, Parodi A, et al. Small intestinal bacterial overgrowth in patients suffering from scleroderma: clinical effectiveness of its eradication. Am J Gastroenterol. 2008;103:1257–62.
doi: 10.1111/j.1572-0241.2007.01758.x
Marie I, Antonietti M, Houivet E, Hachulla E, Maunoury V, Bienvenu B, et al. Gastrointestinal mucosal abnormalities using videocapsule endoscopy in systemic sclerosis. Aliment Pharmacol Ther. 2014;40:189–99.
doi: 10.1111/apt.12818
Camilleri M, Parkman HP, Shafi MA, Abell TL, Gerson L. American College of Gastroenterology. Clinical guideline: management of gastroparesis. Am J Gastroenterol. 2013;108:18–37.
doi: 10.1038/ajg.2012.373
Palsson OS, Whitehead WE, van Tilburg MA, Chang L, Chey W, Crowell MD, et al. Development and validation of the Rome IV diagnostic questionnaire for adults. Gastroenterology. 2016;150:1481–91.
doi: 10.1053/j.gastro.2016.02.014
Carayon P. Guidelines of the French Society of Digestive Endoscopy: total colonoscopy indications. The Council of the French Society of digestive endoscopy (SFED). Endoscopy. 2000;32:434–5.
doi: 10.1055/s-2000-9006
https://www.has-sante.fr/portail/upload/docs/application/pdf/gastro_endoscopy.pdf .
Couturier O, Victor G, Faivre-Chauvet A, Baulieu F, Le Rest C, Bridji B, et al. Guide de bonnes pratiques en scintigraphie de la vidange gastrique. Méd Nucl. 2002;26:211–9.
Harrell F. Regression modeling strategies: with applications to linear models, logistic regression, and survival analysis. New York: Springer; 2001.
doi: 10.1007/978-1-4757-3462-1
Chai J, Herrmann DN, Stanton M, Barbano RL, Logigian EL. Painful small-fiber neuropathy in Sjogren syndrome. Neurology. 2005;65:925–7.
doi: 10.1212/01.wnl.0000176034.38198.f9
Retamozo S, Acar-Denizli N, Rasmussen A, Horváth IF, Baldini C, Priori R, et al. Systemic manifestations of primary Sjögren's syndrome out of the ESSDAI classification: prevalence and clinical relevance in a large international, multi-ethnic cohort of patients. Clin Exp Rheumatol. 2019;37:97–106.
pubmed: 31464664
Krogh K, Asmussen K, Stengaard-Pedersen K, Laurberg S, Deleuran BW. Bowel symptoms in patients with primary Sjögren's syndrome. Scand J Rheumatol. 2007;36:407–9.
doi: 10.1080/03009740701340222
Sandhya P, Jeyaseelan L, Scofield RH, Danda D. Clinical characteristics and outcome of primary Sjogren's syndrome: A large Asian Indian cohort. Open Rheumatol J. 2015;9:36–45.
doi: 10.2174/1874312901409010036
Pavlakis PP, Alexopoulos H, Kosmidis ML, Mamali I, Moutsopoulos HM, Tzioufas AG, et al. Peripheral neuropathies in Sjögren's syndrome: a critical update on clinical features and pathogenetic mechanisms. J Autoimmun. 2012;39:27–33.
doi: 10.1016/j.jaut.2012.01.003
Kovács L, Papós M, Takács R, Róka R, Csenke Z, Kovács A, et al. Autonomic nervous system dysfunction involving the gastrointestinal and the urinary tracts in primary Sjögren’s syndrome. Clin Exp Rheumatol. 2003;21:697–703.
pubmed: 14740447
Goodman BP, Crepeau A, Dhawan PS, Khoury JA, Harris LA. Spectrum of autonomic nervous system impairment in Sjögren syndrome. Neurologist. 2017;22:127–30.
doi: 10.1097/NRL.0000000000000134
Park K, Haberberger RV, Gordon TP, Jackson MW. Antibodies interfering with the type 3 muscarinic receptor pathway inhibit gastrointestinal motility and cholinergic neurotransmission in Sjögren's syndrome. Arthritis Rheum. 2011;63:1426–34.
doi: 10.1002/art.30282
Smith AJ, Jackson MW, Wang F, Cavill D, Rischmueller M, Gordon TP. Neutralization of muscarinic receptor autoantibodies by intravenous immunoglobulin in Sjögren syndrome. Hum Immunol. 2005;66:411–6.
doi: 10.1016/j.humimm.2005.01.020
Hammar O, Ohlsson B, Wollmer P, Mandl T. Impaired gastric emptying in primary Sjogren’s syndrome. J Rheumatol. 2010;37:2313–8.
doi: 10.3899/jrheum.100280
Geyl S, Jacques J, Parreau S, Cypierre A, Tabouret T, Gondran G, et al. Gastroparesis may be the cause of unexplained dyspepsia in patients with primary Sjögren syndrome. Rev Med Interne. 2018;39:427–30.
doi: 10.1016/j.revmed.2018.02.007
Martel C, Gondran G, Launay D, Lalloué F, Palat S, Lambert M, et al. Active immunological profile is associated with systemic Sjögren’s syndrome. J Clin Immunol. 2011;31:840–7.
doi: 10.1007/s10875-011-9553-3
Carvajal Alegria G, Guellec D, Mariette X, Gottenberg JE, Dernis E, Dubost JJ, et al. Epidemiology of neurological manifestations in Sjögren's syndrome: data from the French ASSESS cohort. RMD Open. 2016;20:e000179.
doi: 10.1136/rmdopen-2015-000179