{"title":"La maladie de Sjögren","authors":"Xavier Mariette","doi":"10.1016/j.monrhu.2022.05.001","DOIUrl":"10.1016/j.monrhu.2022.05.001","url":null,"abstract":"","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83376849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sjögren primitif et Sjögren associé","authors":"Renaud Felten , Alain Meyer , Jacques-Eric Gottenberg","doi":"10.1016/j.monrhu.2022.03.005","DOIUrl":"10.1016/j.monrhu.2022.03.005","url":null,"abstract":"<div><p>Sjögren's syndrome (SS) is a systemic autoimmune disease for which diagnosis is difficult and often delayed because of its highly variable clinical presentation. SS may be primary (pSS) or associated with another systemic or organ-specific autoimmune disease. The typical clinical presentation is a dry oculo-buccal syndrome associated with fatigue and joint and muscle pain. Systemic involvement is seen in more than one third of patients, including lymphoma, and may reveal the disease. International consensus criteria have been established to enable a reliable diagnosis to be made, so that follow-up and appropriate therapeutic measures can be proposed as early as possible. These criteria, which take into account clinical, immunological and histological parameters, are easily applicable in everyday practice, and also make it possible to eliminate the many differential diagnoses of a dry syndrome. The association of SS with another systemic autoimmune disease (lupus, rheumatoid arthritis, systemic scleroderma,…) should be investigated because SS and the associated autoimmune disease may mutually modify their clinical, biological and evolutionary profiles. This leads to the evolution of the concept of “secondary” SS towards that of “associated” SS.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84223236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eric Hachulla, David Launay, Vincent Sobanski, Sébastien Sanges, Emmanuel Ledoult
{"title":"Quand penser à un syndrome de Sjögren primitif ?","authors":"Eric Hachulla, David Launay, Vincent Sobanski, Sébastien Sanges, Emmanuel Ledoult","doi":"10.1016/j.monrhu.2022.03.001","DOIUrl":"10.1016/j.monrhu.2022.03.001","url":null,"abstract":"<div><p>Primary Sjögren's syndrome (SS) or Sjögren disease is an autoimmune disorder with a high female ratio (9:1) with a peak of frequency around 50-year-old, but there are also cases with early onset before the age of 20. Forms with the classic triad of dryness, fatigue and pain are a common mode of entry into the disease and account for about 30% of patients with primary SS. Systemic involvement with one or more visceral manifestations is seen in about 70% of cases. Late Raynaud's phenomenon, bronchiolar involvement, interstitial lung disease, synovitis, neuropathies (particularly sensory neuropathies), tubulointerstitial nephritis, and parotid enlargement are all possible entry points to the disease since the dryness may be in the background. Finally, SS should also be considered in cases of cryoglobulinemic vasculitis, which often combines membranoproliferative glomerulonephritis, purpura, livedo and multiple mononeuropathy. More rarely, it is the discovery of a MALT lymphoma or the occurrence of a congenital atrioventricular heart block that will lead to the diagnosis of SS.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89463822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Maladie de Sjögren : risque de lymphome et de myélome","authors":"Gaetane Nocturne","doi":"10.1016/j.monrhu.2022.03.003","DOIUrl":"10.1016/j.monrhu.2022.03.003","url":null,"abstract":"<div><p>Patients with Sjögren's disease (pSS) are at increased risk of lymphoid hemopathy. The development of lymphoma is the most serious complication of SJS. It occurs in 5 to 10% of the patients. Lymphomas in pSS are most often extra-nodal marginal zone non-Hodgkin's B-cell lymphomas that develop from the mucosa associated lymphoid tissue. They frequently occur in the salivary glands, which are the target organ of this autoimmune disease. The development of lymphoma in pSS is a multistep process related to chronic antigenic stimulation of B cells. This update reviews the main predictive factors for lymphoma in pSS and also the practical diagnostic and therapeutic management. In addition, it reviews the risk of myeloma in pSS, a much lesser known complication that is almost as common as lymphoma.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75407835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Les complications systémiques de la maladie de Sjögren (ou syndrome de Sjögren primitif)","authors":"Alice Tison, Valérie Devauchelle-Pensec","doi":"10.1016/j.monrhu.2022.04.001","DOIUrl":"10.1016/j.monrhu.2022.04.001","url":null,"abstract":"<div><p>Primary Sjögren syndrome (pSS) is a progressive autoimmune disease characterized by sicca and systemic manifestations that are frequent and potentially severe, especially when related to B cell activity or the presence of cryoglobulinemia, but the pathological role of the anti-SSA antibodies has never been demonstrated. The frequency of the systemic manifestations in pSS is differentially evaluated related to disease duration or the methods used to detect them, but they are supposed to concern 20 to 70% of the patients. The systemic manifestations can be artificially divided in two types: the life-threatening manifestations (lymphoma, vasculitis with cryoglobulinemia, central nervous system involvement, ganglioneuronopathy and membranoproliferative glomerulonephritis) and the others manifestations. However, the mortality rate in pSS is similar to the general population. The more frequent and easy to evaluate systemic manifestations have been gathered in the ESSDAI score (<em>EULAR Sjogren's Syndrome Disease Activity Index</em>), an international consensual score used in clinical trials and recently incorporated in the STAR index (<em>Sjogren's Tool for Assessing Response</em>).</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73434398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Baptiste Chevet , Laurent Y. Chiche , Valérie Devauchelle-Pensec , Divi Y.K. Cornec
{"title":"Maladie de Sjögren : rare ou fréquent ?","authors":"Baptiste Chevet , Laurent Y. Chiche , Valérie Devauchelle-Pensec , Divi Y.K. Cornec","doi":"10.1016/j.monrhu.2022.02.005","DOIUrl":"10.1016/j.monrhu.2022.02.005","url":null,"abstract":"<div><p>While several criteria for classification have been used for epidemiological studies about primary Sjögren syndrome (pSS), it remains unclear if pSS is an orphan disease. Among 11 analyses retrieved from 9 population-based studies, 8 show a prevalence lower than the orphan disease threshold (50/100,000 inhabitants). In two meta-analyses, prevalence is 39 to 43 per 100,000 inhabitants. There is no difference among prevalence in studies using or not classification criteria. ACR/EULAR 2016 criteria have not been used yet. Women are 6 to 9-fold more involved than men in pSS, and incidence for diagnosis is at the highest between 60 and 70 years old. Although Asian people are the most likely to present pSS, Whites are also more likely than Blacks or Hispanics. Collectively, pSS shall be now considered as an orphan disease, with important implications for clinicians, for development of new therapies and for national health programs.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87266622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Atteintes articulaires dans le syndrome de Sjögren primitif","authors":"Claire I. Daïen , Jacques Morel","doi":"10.1016/j.monrhu.2022.03.002","DOIUrl":"https://doi.org/10.1016/j.monrhu.2022.03.002","url":null,"abstract":"<div><p>Joint involvement is one of the most common extra-glandular manifestations in primary Sjögren's syndrome (pSS), affecting almost half of the patients with clinical arthritis in 16 %. Most commonly, these are symmetrical arthritis, affecting fewer than 5 joints. Ultrasound shows grade 1 or 2 synovitis, with a positive doppler signal in less than a fourth of cases, and tenosynovitis, mostly of the finger flexors. Radiographs should not show erosion. In presence of erosions on ultrasound or MRI, which may be found on MCP and wrists, RA with secondary SS should be excluded. Five to 10 % of patients with SSp have anti-CCP antibodies. The presence of anti-CCP antibodies does not necessarily exclude the diagnosis of SSp, but it should alert to the risk of further development of RA, therefore requiring radiographic follow-up even if the pSS has been evolving for many years. Joint involvement has a good prognosis and appears to be a predictor of a favourable clinical course. Treatment should be guided by the level of clinical activity and should be based on NSAIDs or corticosteroids ±<!--> <!-->hydroxychloroquine. Synthetic disease-modifying anti-rheumatic drugs should be offered for corticosteroid sparing.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138251005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment suivre un patient atteint du syndrome de Sjögren ?","authors":"Elodie Rivière, Rakiba Belkhir, Gaetane Nocturne, Xavier Mariette, Raphaèle Seror","doi":"10.1016/j.monrhu.2022.04.003","DOIUrl":"10.1016/j.monrhu.2022.04.003","url":null,"abstract":"<div><p>In primary Sjögren's syndrome (pSS), patients may present with heterogeneous symptoms. The triad of characteristic symptoms is frequent and includes dryness, fatigue, and pain. Also, 30 to 40% of patients may develop systemic damage. Thus, pSS patients’ follow-up is individualized and must be adapted to the patient clinical and biological phenotype. The modalities and the frequency of the follow-up depend on the presence or not of systemic complications, or their risk factors. As pSS is a rare disease, it is recommended to organize its management in collaboration with reference centers. pSS management is multidisciplinary and involves different health professionals depending on the initial damage characteristics and the evolution. The aim of the follow-up is to determine the activity and severity of the disease, as well as to detect occurrence of systemic complications. It assesses the efficacy and tolerance of treatments and includes the search for comorbidities. In addition, risk factors of lymphoma must be regularly reassessed. Regular monitoring of ophthalmologic and oral status is required. Recent EULAR guidelines address the management of the triad of dryness, fatigue and pain, and detail the management of systemic involvement. In addition, the “Protocole National de Diagnostic et de Soins” has been recently established and presents a clear strategy for patient management and follow-up. Finally, therapeutic education is a pillar of pSS management, allowing patients to be active in their disease follow-up.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74044521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Traitements futurs de la maladie de Sjögren","authors":"Raphaèle Seror, Gaetane Nocturne, Xavier Mariette","doi":"10.1016/j.monrhu.2022.03.006","DOIUrl":"https://doi.org/10.1016/j.monrhu.2022.03.006","url":null,"abstract":"<div><p>Sjögren's disease is a systemic autoimmune disease characterized by a triad of symptoms affecting all patients (dryness, pain, and fatigue) and systemic involvement that can affect one-third of patients. The management of patients has long suffered from the lack of effective treatments. However, knowledge of the epidemiology, classification criteria, assessment of systemic activity (ESSDAI) and patient criteria (ESSPRI) has progressed over the last decade. Similarly, advances in the understanding of the pathogenesis of the disease have led to a more targeted therapeutic approach. In this review, we will summarize the advances that have been made in outcome assessment that will shape future trials. We will also provide an overview of promising drugs being evaluated in Sjögren's disease.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138251214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prise en charge de l’infection sur articulation native : le point de vue du chirurgien","authors":"Simon Marmor , Luc Lhotellier","doi":"10.1016/j.monrhu.2021.12.001","DOIUrl":"10.1016/j.monrhu.2021.12.001","url":null,"abstract":"<div><p>Native septic arthritis is a medical and surgical emergency, both diagnostic and therapeutic. Its management must be dynamic, multidisciplinary and adapted to joint damage stage because the preservation of function will depend on time to management and the good therapeutic which will have to be regularly reassessed. If iterative needle aspiration are possible in the first hours of fluid arthritis, they must quickly give way to arthroscopic lavage in unfavorable outcome. At synovial arthritis stage, a large synovectomy should be performed either by arthrotomy or arthroscopy, then at the final osteoarthritis stage, joint resection is required. Source of frequent sequelae, septic arthritis imposed in the short or medium term, joint reconstructions by prostheses in many patients. This procedure will require special care because of the significant residual infectious risk.</p></div>","PeriodicalId":101125,"journal":{"name":"Revue du Rhumatisme Monographies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74222473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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