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A esclerose sistémica é uma doença rara caracterizada por inflamação sistémica do tecido
conjuntivo, mediada por resposta auto-imune, que resulta em fibrose dos tecidos. A
osteoporose é uma doença óssea metabólica, que pode ocorrer secundariamente à
inflamação condicionada pela esclerose sistémica e a fatores relacionados com a doença,
uso de corticoesteróides e deficiência de vitamina D. O diagnóstico é estabelecido por
osteodensitometria, segundo as Normas da Direção Geral da Saúde.
Este estudo propôs-se estudar uma população definida de doentes, numa unidade de
Reumatologia, com o diagnóstico de esclerose sistémica, quanto à prevalência de
osteoporose. Retrospetivamente, através da consulta dos processos clínicos, foram
incluídos vinte e cinco (25) doentes, e recolhidas características como forma de
apresentação da doença, perfil imunológico, manifestações clínicas e parâmetros biológicos.
Foram igualmente recolhidos dados relativamente à concentração sérica de vitamina D,
resultados de osteodensitometria, história de fraturas prévias, tratamento antiosteoporótico e suplementação com cálcio e/ou vitamina D.
Entre os vinte e cinco (25) doentes incluídos, com idade média atual de 61,1 anos e tempo
médio de evolução da doença 5,70 anos, vinte e dois (22) eram do sexo feminino. Em apenas
catorze (14) foi realizado osteodensitometria. Verificou-se osteoporose em quatro (4) dos
doentes incluídos na amostra (16%). Vinte (20) dos indivíduos incluídos na amostra
apresentaram valor inferior ao normal de vitamina D sérico (80,0%). Três (3) realizam
tratamento anti-osteoporótico (12,0%). Quinze (15) realizam suplementação com vitamina
D (60,0%), sendo que sete (7) concomitantemente com cálcio+vitamina D (28,0%).
Apesar de no presente estudo se ter verificado uma reduzida proporção de doentes com
diminuição da DMO, estudos anteriores estabelecem uma relação entre fatores da doença e
alterações do metabolismo ósseo e sua densidade.
Systemic sclerosis is a rare disease, which is characterized by a systemic inflammation of the connective tissue, mediated by an auto-immune response, with consequent tissue fibrosis. Osteoporosis is a metabolic bone disease, which can occur secondarily to the inflammation conditioned by the systemic sclerosis and by other disease factors, corticosteroids use and vitamin D deficiency. Its diagnosis is established with osteodensitometry, according to the standardized norms of the portuguese health’s regulatory headship. This study proposed itself to study the prevalence of osteoporosis in a defined population of patients, with the diagnosis of systemic sclerosis, in a Rheumatology Unit. Twenty-five (25) patients’ health records were consulted and data like disease presentation, immunologic profile, clinic manifestations and biologic parameters were collected. Data concerning osteodensitometry results, vitamin D concentration, past history of fracture, use of antiosteoporotic drugs or supplementation with calcium and/or vitamin D were also collected. The average age of the twenty-five (25) patients included was 61,1 years and 5,70 years is presented as the average time of disease-evolution. Twenty-two (22) were female. Only fourteen (14) have done osteodensitometry before. Four (4) patients of the population had osteoporosis (16,0%). Twenty (20) had vitamin D concentration lower than the normal range (80,0%). Three (3) were under anti-osteoporotic treatment (12,0%). Fifteen (15) were under supplementation with vitamin D (60,0%), seven (7) of them simultaneously with calcium+vitamin D (28,0%). Despite the low proportion of patients with lower bone mineral density, previous studies have established an association between disease factor and bone metabolism and density alterations.
Systemic sclerosis is a rare disease, which is characterized by a systemic inflammation of the connective tissue, mediated by an auto-immune response, with consequent tissue fibrosis. Osteoporosis is a metabolic bone disease, which can occur secondarily to the inflammation conditioned by the systemic sclerosis and by other disease factors, corticosteroids use and vitamin D deficiency. Its diagnosis is established with osteodensitometry, according to the standardized norms of the portuguese health’s regulatory headship. This study proposed itself to study the prevalence of osteoporosis in a defined population of patients, with the diagnosis of systemic sclerosis, in a Rheumatology Unit. Twenty-five (25) patients’ health records were consulted and data like disease presentation, immunologic profile, clinic manifestations and biologic parameters were collected. Data concerning osteodensitometry results, vitamin D concentration, past history of fracture, use of antiosteoporotic drugs or supplementation with calcium and/or vitamin D were also collected. The average age of the twenty-five (25) patients included was 61,1 years and 5,70 years is presented as the average time of disease-evolution. Twenty-two (22) were female. Only fourteen (14) have done osteodensitometry before. Four (4) patients of the population had osteoporosis (16,0%). Twenty (20) had vitamin D concentration lower than the normal range (80,0%). Three (3) were under anti-osteoporotic treatment (12,0%). Fifteen (15) were under supplementation with vitamin D (60,0%), seven (7) of them simultaneously with calcium+vitamin D (28,0%). Despite the low proportion of patients with lower bone mineral density, previous studies have established an association between disease factor and bone metabolism and density alterations.
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Esclerose Sistémica Osteoporose Reumatologia Vitamina D