Seelmann Daniela, Poblete María Paz, Saavedra Silvana, Madrid Ana María, von Muhlenbrock Christian, Estay Camila, Goecke Annelise
Rheumatology Section, Medicine Department, Hospital Clínico de la Universidad de Chile, Santiago, Chile.
Rheumatology Section, Medicine Department, Hospital Clínico de la Fuerza Aérea de Chile, Santiago, Chile.
Rheumatol Adv Pract. 2024 Mar 12;8(2):rkae041. doi: 10.1093/rap/rkae041. eCollection 2024.
Gastric involvement in patients with early systemic sclerosis (SSc) has not been previously investigated. We aim to evaluate the association of gastric dysrhythmias with gastrointestinal (GI) symptoms and nailfold video capillaroscopy (NVC).
Cross-sectional study. Patients with early SSc, completed the UCLA GIT 2.0 questionnaire, performed an NVC, and a surface Electrogastrography (EGG). Descriptive statistics was used for demographic and clinical characteristics and Fisher and Kendall Tau tests were used for association analysis.
75 patients were screened, 30 patients were consecutively enrolled, 29 performed the EGG and 1 patient had a non-interpretable NVC. 29/30 were female with a mean age of 48.7 years (25-72). The mean disease duration from the first non-RP symptom was 22.6 +/-10.8 months and most of the patients had limited disease (76.6%). Total GIT 2.0 score symptoms were moderate-severe in 63% of the participants and 28/29 had an abnormal EGG. Bradygastria was the most common pattern present in 70% of the participants. NVC patterns: 17% early, 34% active, 28% scleroderma-like, 14% non-specific, and 2 patients had a normal NVC. There was no association between severe GI symptoms or NVC patterns and severely abnormal EGG, but the presence of bradygastria was associated with severe impairment in the social functioning area (p 0.018).
Gastric dysmotility is common in early SSc and there is a lack of correlation between GI symptoms and NVC scleroderma patterns. EGG is a sensitive, cheap, and non-invasive exam, that may be an alternative to early diagnosis of GI involvement.
既往尚未对早期系统性硬化症（SSc）患者的胃部受累情况进行研究。我们旨在评估胃节律紊乱与胃肠道（GI）症状及甲襞视频毛细血管镜检查（NVC）之间的关联。
横断面研究。早期SSc患者完成加州大学洛杉矶分校胃肠道2.0问卷，进行NVC及体表胃电图（EGG）检查。描述性统计用于人口统计学和临床特征分析，Fisher检验和Kendall Tau检验用于关联分析。
共筛查75例患者，连续纳入30例，29例进行了EGG检查，1例NVC检查结果无法解读。30例患者中29例为女性，平均年龄48.7岁（25 - 72岁）。从首个非雷诺现象症状开始计算的平均病程为22.6±10.8个月，大多数患者病情局限（76.6%）。63%的参与者胃肠道2.0总分症状为中重度，28/29例EGG检查异常。胃动力不足是最常见的模式，70%的参与者存在该情况。NVC模式：17%为早期，34%为活动期，28%为硬皮病样，14%为非特异性，2例NVC正常。严重的GI症状或NVC模式与严重异常的EGG之间无关联，但胃动力不足的存在与社交功能领域的严重受损相关（p = 0.018）。
胃动力障碍在早期SSc中很常见，GI症状与NVC硬皮病模式之间缺乏相关性。EGG是一种敏感、廉价且无创的检查，可能是早期诊断GI受累的一种替代方法。
