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Advisor(s)
Abstract(s)
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.
Description
Keywords
Esclerose Sistémica Osteoporose Reumatologia Vitamina D