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Ginecología y Obstetricia de México

Federación Mexicana de Ginecología y Obstetricia, A.C.
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2009, Number 09

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Ginecol Obstet Mex 2009; 77 (09)

Squamous intraepithlelial lesions in women’s lupus

Mercado U
Full text How to cite this article

Language: Spanish
References: 9
Page: 423-427
PDF size: 213.50 Kb.


Key words:

Systemic lupus erythematosus, squamous intraepithelial lesions, traditional risk factors, immunosuppressive drugs.

ABSTRACT

Background: previous studies have suggested an association between systemic lupus erythematosus (SLE), abnormal cervical smears and squamous intraepithelial lesions (SIL), but the underlying cause of this association is not well defined.
Objective: To review Pap smear and biopsy results in SLE women compared with healthy controls and to identify traditional risk factors associated with abnormal smears. Retrospective cohort study. Sixty-two SLE patients and 1719 controls were included. Women with abnormal Pap smear results were referred to colposcopic biopsy histology. Information on traditional risk factors was obtained. Among SLE patients, activity score (Mex-SLEDAI) and immunosuppressive drugs exposure also were determined.
Results: Fourteen (22%) out of 62 patients had abnormal Pap smear results, compared with 120 (7%) out of 1719 controls. Thirteen (92%) out of 14 patients showed SIL by histological examination, compared with 27 (22%) out of 120 controls. Two SLE women had condylomata. There were no significant differences in the use of immunosuppressive agents among SLE patients with and without SIL.
Conclusion: Abnormal Pap smears, SIL by biopsy and changes in the sexual behavioral were more common among SLE patients than in controls. The immunosuppressive drug exposure was not associated with abnormal Pap smears.


REFERENCES

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  2. Bernastky S, Ramsay-Goldman R, Gordon C, et al. Factors associated with abnormal Pap results in systemic lupus erythematosus. Rheumatology 2004; 43:1386-9.

  3. Nyberg G, Eriksson O, Westberg G. Increased incidence of cervical atypia in women with systemic lupus erythematosus treated with chemotherapy. Arthritis Rheum 1981;24:648-50.

  4. Ognenovski VM, Marder W, Somers EC, et al. Increased incidence of cervical intraepithelial neoplasia in women with systemic lupus erythematosus treated with intravenous cyclophosphamide. J Rheumatol 2004;31:1763-7.

  5. Canoso J, Cohen A. Malignancy in a series of 70 patients with lupus erythematosus. Arthritis Rheum 1974;17:383-90.

  6. Tam LS, Chan AY, Chan PK, Li EK. Increased prevalence of squamous intraepithelial lesions in systemic lupus erythematosus. Arthritis Rheum 2004;50:3619-25.

  7. Guzman J, Cardiel MH, Arce-Salinas A, et al. Measurement of disease activity in systemic lupus erythematosus. Prospective validation of 3 clinical indices. J Rheumatol 1992;19:1551-58.

  8. Nath R, Mant C, Luxton J, Hughes G, et al. High risk of human papillomavirus type 16 infections and of development of cervical squamous intraepithelial lesions in systemic lupus erythematosus patients. Arthritis Care & Res 2007;57:619-25.

  9. Schneider V, Kay S, Lee H. Immunosuppression as a high risk factor in the development of condyloma acuminatum and squamous neoplasia of the cervix. Acta Cytol 1983;27:220-4.




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Ginecol Obstet Mex. 2009;77