Rheumatology A Dpt, Paris Descartes University, Sorbonne Paris Cite, Cochin Hospital, APHP, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France.
Autoimmun Rev. 2013 Sep;12(11):1052-7. doi: 10.1016/j.autrev.2013.05.002. Epub 2013 Jun 19.
Several epidemiological studies have revealed the co-occurrence of other autoimmune diseases (AIDs) within patients with systemic sclerosis (SSc). However, some of these studies were based on small cohorts and wide ranges of prevalence have been reported. Therefore to overcome these limitations of individual studies, we sought to perform a meta-analysis to determine the accurate prevalence of polyautoimmunity in SSc.
We performed a systematic review and a meta-analysis of literature in MEDLINE and Embase databases from January 1960 to March 2013. All cohort studies reporting on prevalence of other AIDs known to be associated with SSc were analyzed. Prevalence of polyautoimmunity and of each AID were then calculated.
Ten studies reporting polyautoimmunity were identified corresponding to a total of 6102 SSc patients. Overall 1432 patients with at least one AID were identified corresponding to a weighted prevalence of polyautoimmunity equal to 25.7% CI 95% [20.1%-31.6%]. Overall 208/5139 SSc-patients had at least two additional AIDs resulting in a weighted prevalence of 3.9% [3.3%-4.4%]. The most prevalent associated AIDs were autoimmune thyroid disease (10.4%) followed by Sjögren's syndrome (7.7%) and dermatopolymyositis/polymyositis (5.6%).
Our results confirm that SSc polyautoimmunity is a frequent condition in SSc affecting a quarter of SSc-patients. The impact on the phenotype and also on the management and therapy will need to be addressed now in further works.
几项流行病学研究揭示了系统性硬化症（SSc）患者中同时存在其他自身免疫性疾病（AIDs）的情况。然而，其中一些研究基于小队列，报道的患病率范围很广。因此，为了克服这些个体研究的局限性，我们试图进行荟萃分析以确定 SSc 中多自身免疫的准确患病率。
我们对 MEDLINE 和 Embase 数据库中的文献进行了系统评价和荟萃分析，时间范围为 1960 年 1 月至 2013 年 3 月。分析了所有报告与 SSc 相关的已知其他 AIDs 患病率的队列研究。然后计算了多自身免疫和每种 AID 的患病率。
确定了 10 项报告多自身免疫的研究，共计 6102 例 SSc 患者。总体而言，有 1432 例患者患有至少一种 AID，加权患病率为 25.7%（95%可信区间[20.1%-31.6%]）。总体而言，5139 例 SSc 患者中有 208 例患者有至少两种其他 AIDs，加权患病率为 3.9%（95%可信区间[3.3%-4.4%]）。最常见的相关 AIDs 是自身免疫性甲状腺疾病（10.4%），其次是干燥综合征（7.7%）和皮肌炎/多发性肌炎（5.6%）。
我们的结果证实，SSc 多自身免疫是 SSc 中的一种常见疾病，影响了四分之一的 SSc 患者。这对表型的影响，以及对管理和治疗的影响，都需要在进一步的工作中加以解决。
