Exocrine pancreatic dysfunction in systemic sclerosis and primary Sjogren’s syndrome patients

Yıl: 2023 Cilt: 15 Sayı: 1 Sayfa Aralığı: 1 - 5 Metin Dili: İngilizce DOI: 10.4274/raed.galenos.2023.92486 İndeks Tarihi: 31-05-2023

Exocrine pancreatic dysfunction in systemic sclerosis and primary Sjogren’s syndrome patients

Öz:
Objective: Gastrointestinal problems are frequently encountered in systemic sclerosis (SSc) and primary Sjogren’s syndrome (pSS). It has been thought that the pancreas were affected by these diseases. It was aimed to investigate exocrine pancreatic insufficiency in SSc and pSS patients and its potential effect on patient’s gastrointestinal problems. Methods: Patients with a diagnosis of SSc or pSS patients, according to 2013 and 2016 American College of Rheumatology/European League Against Rheumatism criteria were consecutively examined. The gastrointestinal quality of life questionnaire was used for functional assessment. Fecal samples were taken from participants and fecal elastase level (fe), which were measured by the ELISA kit. Results: Forty SSc and forty-one pSS patients were enrolled in the study. Groups had similar disease duration, age, and sex distribution. Fe levels were not different between the groups, Healthy control groups had median fe level of 516 μg/g, whereas SSc patients had 437±128 μg/g and pSS patients had 428±149 μg/g. The proportion of patients exhibiting pathological fecal elastase levels were also the same between the groups (12.2% versus 7.5% respectively). However, the functional survey score was worse in the SSc group. Conclusion: Gastrointestinal problems were prevalent in connective tissue disorders, especially in SSc patients. Although pancreatic exocrine dysfunction is rare in these patient groups, its contribution to the development of these complaints is limited.
Anahtar Kelime:

Sistemik skleroz ve primer Sjögren sendromu hastalarında ekzokrin pankreas disfonksiyonu

Öz:
Amaç: Skleroderma (SSc) ve primer Sjögren sendromunda (pSS) gastrointestinal problemlerle sıklıkla karşılaşılır. Pankreasın bu hastalıklardan etkilendiği düşünülmektedir. Bu çalışmada, SSc ve pSS hastalarında ekzokrin pankreas yetmezliğinin ve hastanın gastrointestinal problemlerine olası etkisinin araştırılması amaçlandı. Yöntem: 2013 ve 2016 Amerikan Romatoloji Birliği/Avrupa Romatoloji Birliği kriterlerine göre SSc veya pSS hastası tanısı alan hastalar incelendi. Fonksiyonel değerlendirme için gastrointestinal yaşam kalitesi anketi kullanıldı. Katılımcılardan dışkı örnekleri alındı ve ELISA kiti ile ölçülen dışkı elastaz düzeyi (fe) bakıldı. Bulgular: Çalışmaya kırk SSc ve kırk bir pSS hastası alındı. Gruplar benzer hastalık süresine, yaş ve cinsiyet dağılımına sahipti. Fe düzeyleri gruplar arasında farklı değildi, SSc hastaları 437±128 μg/g ve pSS hastaları 428±149 μg/g idi. Patolojik fekal elastaz seviyeleri sergileyen hastaların oranı da gruplar arasında aynıydı (sırasıyla %12,2’ye karşı %7,5). Ancak, fonksiyonel anket puanları SSc grubunda daha kötüydü Sonuç: Gastrointestinal problemler, SSc hastalarında daha çok olmak üzere, bağ dokusu romatizması olan bireylerde yaygın olarak görülmektedir. Pankreatik ekzokrin disfonksiyonu bu hasta gruplarında nadir görülmekle beraber, bu şikayetlerin gelişmesine katkısı sınırldır.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Bossini-Castillo L, López-Isac E, Mayes MD, Martín J. Genetics of systemic sclerosis. Semin Immunopathol 2015;37:443-51.
  • 2. Both T, Dalm VA, van Hagen PM, van Daele PL. Reviewing primary Sjögren’s syndrome: beyond the dryness - From pathophysiology to diagnosis and treatment. Int J Med Sci 2017;14:191-200.
  • 3. McFarlane IM, Bhamra MS, Kreps A, et al. Gastrointestinal Manifestations of Systemic Sclerosis. Rheumatology (Sunnyvale) 2018;8:235.
  • 4. Ostuni PA, Gazzetto G, Chieco-Bianchi F, et al. Pancreatic exocrine involvement in primary Sjögren’s syndrome. Scand J Rheumatol 1996;25:47-51.
  • 5. Jaovisidha K, Csuka ME, Almagro UA, Soergel KH. Severe gastrointestinal involvement in systemic sclerosis: report of five cases and review of the literature. Semin Arthritis Rheum 2005;34:689-702.
  • 6. Dreiling DA, Soto MJ. The pancreatic involvement in disseminated “collagen” disorders. Studies of pancreatic secretion in patients with scleroderma and Sjögren’s “disease”. Am J Gastroenterol 1976;66:546-53.
  • 7. Cobden I, Axon AT, Rowell NR. Pancreatic exocrine function in systemic sclerosis. Br J Dermatol 1981;105:189-93.
  • 8. Hendel L, Worning H. Exocrine pancreatic function in patients with progressive systemic sclerosis. Scand J Gastroenterol 1989;24:461-6.
  • 9. Shawis TN, Chaloner C, Herrick AL, Jayson MI. Pancreatic function in systemic sclerosis. Br J Rheumatol 1996;35:298-9.
  • 10. Rhodus NL, Bloomquist C, Liljemark W, Bereuter J. Prevalence, density, and manifestations of oral Candida albicans in patients with Sjögren’s syndrome. J Otolaryngol 1997;26:300-5.
  • 11. Afzelius P, Fallentin EM, Larsen S, Møller S, Schiødt M. Pancreatic function and morphology in Sjögren’s syndrome. Scand J Gastroenterol 2010;45:752-8.
  • 12. Kauppi M, Kankaanpää E, Kautiainen H. Exocrine dysfunction of the pancreas in patients with chronic polyarthritis. J Clin Rheumatol 2001;7:166-9.
  • 13. Bozovic G, Pullerits R, Ståhl A, et al. Exocrine pancreatic function is preserved in systemic sclerosis. Arthritis Research & Therapy 2019;21:1-8.
  • 14. Sisman P, Yucel E. Evaluation of pancreatic exocrine functions in rheumatoid arthritis. Bratisl Lek Listy 2018;119:494-7.
  • 15. Frech TM, Khanna D, Maranian P, Frech EJ, Sawitzke AD, Murtaugh MA. Probiotics for the treatment of systemic sclerosisassociated gastrointestinal bloating/ distention. Clin Exp Rheumatol 2011;29(2 Suppl 65):S22-5.
  • 16. Weintraub A, Blau H, Mussaffi H, et al. Exocrine pancreatic function testing in patients with cystic fibrosis and pancreatic sufficiency: a correlation study. J Pediatr Gastroenterol Nutr 2009;48:306-10.
  • 17. Chowdhury SD, Kurien RT, Ramachandran A, et al. Pancreatic exocrine insufficiency: Comparing fecal elastase 1 with 72-h stool for fecal fat estimation. Indian J Gastroenterol 2016;35:441-4.
  • 18. Vanga RR, Tansel A, Sidiq S, El-Serag HB, Othman MO. Diagnostic Performance of Measurement of Fecal Elastase-1 in Detection of Exocrine Pancreatic Insufficiency: Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol 2018;16:1220-8. e4.
  • 19. Eypasch E, Wood-Dauphinée S, Williams JI, Ure B, Neugebauer E, Troidl H. Der Gastrointestinale Lebensqualitätsindex (GLQI). Ein klinimetrischer Index zur Befindlichkeitsmessung in der gastroenterologischen Chirurgie [The Gastrointestinal Quality of Life Index. A clinical index for measuring patient status in gastroenterologic surgery]. Chirurg 1993;64:264-74.
  • 20. Bitik B, Tufan A, Mercan R, et al. AB0635 Gastrointestinal quality of life index (GIQLI) in patients with primary sjÖgren’s syndrome. Ann Rheum Dis 2013;71(Suppl 3):675.
  • 21. Shiboski CH, Shiboski SC, Seror R, et al. 2016 American College of Rheumatology/European League Against Rheumatism classification criteria for primary Sjögren’s syndrome: a consensus and data-driven methodology involving three international patient cohorts. Ann Rheum Dis 2017;76:9-16.
  • 22. Van Den Hoogen F, Khanna D, Fransen J, et al. 2013 classification criteria for systemic sclerosis: an American College of Rheumatology/European League against Rheumatism collaborative initiative. Ann Rheum Dis 2013;65:2737-47.
  • 23. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159-74.
  • 24. Nietert PJ, Mitchell HC, Bolster MB, Curran MY, Tilley BC, Silver RM. Correlates of depression, including overall and gastrointestinal functional status, among patients with systemic sclerosis. J Rheumatol 2005;32:51-7.
  • 25. Harrison E, Herrick AL, McLaughlin JT, Lal S. Malnutrition in systemic sclerosis. Rheumatology (Oxford) 2012;51:1747-56.
  • 26. Sumii T, Ando B, Sakai K. Chronic pancreatitis and pancreatic dysfunction associated with Sjögren’s syndrome. Nihon Rinsho 1995;53:2525-9.
  • 27. Candelli M, Manganelli C, Nista E, et al. Evaluation of subclinical exocrine pancreatic involvement in primitive Sjogren’s syndrome (pSS) by mixed triglyceride breath test and fecal chymotrypsin and its relation with Schirmer’s test. Digestive and Liver Disease 2000:A128.
  • 28. Coll J, Navarro S, Tomas R, Elena M, Martinez E. Exocrine pancreatic function in Sjögren’s syndrome. Arch Intern Med 1989;149:848-52.
  • 29. Pal B, Griffiths ID, Katrak A, Junglee D, Dandona P. Salivary amylase and pancreatic enzymes in Sjögren’s syndrome. Clin Chem 1987;33:305-7.
APA Satış H, Bilici Salman R, Babaoglu H, Atas N, Avanoglu Guler A, KARADENİZ H, Goker B, HAZNEDAROGLU S, öztürk m, TUFAN A, Arslan B, Güven S (2023). Exocrine pancreatic dysfunction in systemic sclerosis and primary Sjogren’s syndrome patients. , 1 - 5. 10.4274/raed.galenos.2023.92486
Chicago Satış Hasan,Bilici Salman Reyhan,Babaoglu Hakan,Atas Nuh,Avanoglu Guler Aslihan,KARADENİZ HAZAN,Goker Berna,HAZNEDAROGLU SEMINUR,öztürk mehmet akif,TUFAN ABDURRAHMAN,Arslan Burak,Güven Serdar Can Exocrine pancreatic dysfunction in systemic sclerosis and primary Sjogren’s syndrome patients. (2023): 1 - 5. 10.4274/raed.galenos.2023.92486
MLA Satış Hasan,Bilici Salman Reyhan,Babaoglu Hakan,Atas Nuh,Avanoglu Guler Aslihan,KARADENİZ HAZAN,Goker Berna,HAZNEDAROGLU SEMINUR,öztürk mehmet akif,TUFAN ABDURRAHMAN,Arslan Burak,Güven Serdar Can Exocrine pancreatic dysfunction in systemic sclerosis and primary Sjogren’s syndrome patients. , 2023, ss.1 - 5. 10.4274/raed.galenos.2023.92486
AMA Satış H,Bilici Salman R,Babaoglu H,Atas N,Avanoglu Guler A,KARADENİZ H,Goker B,HAZNEDAROGLU S,öztürk m,TUFAN A,Arslan B,Güven S Exocrine pancreatic dysfunction in systemic sclerosis and primary Sjogren’s syndrome patients. . 2023; 1 - 5. 10.4274/raed.galenos.2023.92486
Vancouver Satış H,Bilici Salman R,Babaoglu H,Atas N,Avanoglu Guler A,KARADENİZ H,Goker B,HAZNEDAROGLU S,öztürk m,TUFAN A,Arslan B,Güven S Exocrine pancreatic dysfunction in systemic sclerosis and primary Sjogren’s syndrome patients. . 2023; 1 - 5. 10.4274/raed.galenos.2023.92486
IEEE Satış H,Bilici Salman R,Babaoglu H,Atas N,Avanoglu Guler A,KARADENİZ H,Goker B,HAZNEDAROGLU S,öztürk m,TUFAN A,Arslan B,Güven S "Exocrine pancreatic dysfunction in systemic sclerosis and primary Sjogren’s syndrome patients." , ss.1 - 5, 2023. 10.4274/raed.galenos.2023.92486
ISNAD Satış, Hasan vd. "Exocrine pancreatic dysfunction in systemic sclerosis and primary Sjogren’s syndrome patients". (2023), 1-5. https://doi.org/10.4274/raed.galenos.2023.92486
APA Satış H, Bilici Salman R, Babaoglu H, Atas N, Avanoglu Guler A, KARADENİZ H, Goker B, HAZNEDAROGLU S, öztürk m, TUFAN A, Arslan B, Güven S (2023). Exocrine pancreatic dysfunction in systemic sclerosis and primary Sjogren’s syndrome patients. Ulusal Romatoloji Dergisi, 15(1), 1 - 5. 10.4274/raed.galenos.2023.92486
Chicago Satış Hasan,Bilici Salman Reyhan,Babaoglu Hakan,Atas Nuh,Avanoglu Guler Aslihan,KARADENİZ HAZAN,Goker Berna,HAZNEDAROGLU SEMINUR,öztürk mehmet akif,TUFAN ABDURRAHMAN,Arslan Burak,Güven Serdar Can Exocrine pancreatic dysfunction in systemic sclerosis and primary Sjogren’s syndrome patients. Ulusal Romatoloji Dergisi 15, no.1 (2023): 1 - 5. 10.4274/raed.galenos.2023.92486
MLA Satış Hasan,Bilici Salman Reyhan,Babaoglu Hakan,Atas Nuh,Avanoglu Guler Aslihan,KARADENİZ HAZAN,Goker Berna,HAZNEDAROGLU SEMINUR,öztürk mehmet akif,TUFAN ABDURRAHMAN,Arslan Burak,Güven Serdar Can Exocrine pancreatic dysfunction in systemic sclerosis and primary Sjogren’s syndrome patients. Ulusal Romatoloji Dergisi, vol.15, no.1, 2023, ss.1 - 5. 10.4274/raed.galenos.2023.92486
AMA Satış H,Bilici Salman R,Babaoglu H,Atas N,Avanoglu Guler A,KARADENİZ H,Goker B,HAZNEDAROGLU S,öztürk m,TUFAN A,Arslan B,Güven S Exocrine pancreatic dysfunction in systemic sclerosis and primary Sjogren’s syndrome patients. Ulusal Romatoloji Dergisi. 2023; 15(1): 1 - 5. 10.4274/raed.galenos.2023.92486
Vancouver Satış H,Bilici Salman R,Babaoglu H,Atas N,Avanoglu Guler A,KARADENİZ H,Goker B,HAZNEDAROGLU S,öztürk m,TUFAN A,Arslan B,Güven S Exocrine pancreatic dysfunction in systemic sclerosis and primary Sjogren’s syndrome patients. Ulusal Romatoloji Dergisi. 2023; 15(1): 1 - 5. 10.4274/raed.galenos.2023.92486
IEEE Satış H,Bilici Salman R,Babaoglu H,Atas N,Avanoglu Guler A,KARADENİZ H,Goker B,HAZNEDAROGLU S,öztürk m,TUFAN A,Arslan B,Güven S "Exocrine pancreatic dysfunction in systemic sclerosis and primary Sjogren’s syndrome patients." Ulusal Romatoloji Dergisi, 15, ss.1 - 5, 2023. 10.4274/raed.galenos.2023.92486
ISNAD Satış, Hasan vd. "Exocrine pancreatic dysfunction in systemic sclerosis and primary Sjogren’s syndrome patients". Ulusal Romatoloji Dergisi 15/1 (2023), 1-5. https://doi.org/10.4274/raed.galenos.2023.92486