Department of Rheumatology, Te Toka Tumai Auckland, Health New Zealand.
Curr Opin Otolaryngol Head Neck Surg. 2024 Dec 1;32(6):383-390. doi: 10.1097/MOO.0000000000000995. Epub 2024 Jul 29.
Dysphagia is a complication of several autoimmune rheumatic diseases and otorhinolaryngologists are likely to be involved in the assessment and management of patients with such conditions. This review provides an update on rheumatic diseases that may cause swallowing impairment, with particular focus on the epidemiology, pathophysiology and management of dysphagia in these conditions.
Dysphagia is a common complication of the following rheumatic diseases: idiopathic inflammatory myopathies, systemic sclerosis, Sjogren's syndrome, systemic lupus erythematosus and rheumatoid arthritis. It may also be a complication of rarer autoimmune conditions such as Bechet's syndrome, sarcoidosis and granulomatosis with polyangiitis. All three stages of swallowing (oral, pharyngeal and oesophageal) may be impaired in these conditions. Both medical therapy and surgical intervention play an important role in the management of autoimmune dysphagia.
The investigation and management of autoimmune dysphagia requires close collaboration between rheumatologists and otorhinolaryngologists. There is a need for further research to establish standardised guidelines on the assessment and management of autoimmune dysphagia.
吞咽困难是几种自身免疫性风湿病的并发症,耳鼻喉科医生可能参与这些疾病患者的评估和管理。本文综述了可能导致吞咽障碍的风湿性疾病,重点介绍了这些疾病中吞咽困难的流行病学、病理生理学和管理。
吞咽困难是特发性炎性肌病、系统性硬化症、干燥综合征、系统性红斑狼疮和类风湿关节炎等风湿性疾病的常见并发症。它也可能是贝切特综合征、结节病和肉芽肿性多血管炎等罕见自身免疫性疾病的并发症。在这些情况下,吞咽的三个阶段(口腔、咽和食管)都可能受损。这些自身免疫性吞咽困难的治疗既包括药物治疗,也包括手术干预。
自身免疫性吞咽困难的调查和管理需要风湿病学家和耳鼻喉科医生之间的密切合作。需要进一步的研究来制定自身免疫性吞咽困难评估和管理的标准化指南。