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2020
OMIG Abstract Methods: A retrospective and longitudinal case series study of patients with primary (pSS) or secondary Sjögren syndrome (sSS) seen between January and October 2019 were conducted. Inclusion criteria comprised patients with a known diagnosis of pSS or sSS, according to the AECG-2016 consensus, who presented with active sterile ulceration in the central or paracentral cornea. An analysis of the signs and symptoms associated with systemic disease activity; the therapeutic status including drug failure, reduction, or discontinuation was performed, as well as levels of serologic biomarkers of inflammation like ESR, CRP, LDH, and autoantibodies determined at the time of ulceration. Results: A total of 19 patients, 17 (89.4%) women, and 2 (10.6%) men with a mean age of 56.7 years were included for analysis. Five (26.3%) patients had a diagnosis of pSS and 14 (73.7%) of sSS. ESR was high in 81.3% of patients and CRP in 61.5% of them. Half of the patients had elevated LDH, individual markers of disease activity such as anti-citrullinated protein antibodies (ACPA’s) were elevated in 44.4% of patients, 28.6% of patients had leukopenia, leukocytosis was present in 7.14% of patients. All patients were considered undertreated at the time of ulcer appearance, requiring systemic therapy adjustment with resultant improvement.
Conclusion: A marked correlation was found between central corneal ulceration and increased systemic disease activity. There was a strong association between serologic biomarkers and undertreatment with disease activity. We consider that appropriate systemic treatment is required as part of the ocular surface management in these patients.
Disclosure: N
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