Document Detail


Clues for previously undiagnosed connective tissue disease in patients with trigeminal neuralgia.
MedLine Citation:
PMID:  20661065     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Connective tissue diseases (CTD) may be associated with idiopathic trigeminal neuralgia (TN). The prevalence and diagnostic implications of this association are, however, not well established.
OBJECTIVES: The objective of this study was to evaluate, in TN patients, if rheumatologic clinical and laboratory findings could contribute to the early diagnosis of rheumatic diseases.
METHODS: Forty-six consecutive TN patients, 67% female, mean disease duration 8.78 +/- 7.25 years, and 47 controls were initially interviewed using a standard questionnaire based on common signs/symptoms of systemic lupus erythematosus, Sjögren syndrome, mixed CTD, and systemic sclerosis. Autoantibodies were detected by standard techniques. Those with rheumatologic complaints or positive autoantibodies were referred to the Rheumatology Outpatient Clinic for a more detailed evaluation. Secondary causes of TN were excluded.
RESULTS: The frequency of Raynaud phenomenon (P = 0.026) and ANA reactivity (P = 0.04) were significantly higher in TN patients compared with controls. Fourteen TN patients were ANA positive. Seven of them reported concomitant rheumatic complaints, and interestingly, diffuse CTD was diagnosed in 4 (57%) of these patients: 1 systemic lupus erythematosus; 2 Sjögren syndrome; and 1 undifferentiated disease with scleritis and positive parotid scintigraphy. In all cases, TN preceded by at least 10 months the rheumatologic signs/symptoms. Moreover, these 4 TN patients with CTD had a higher frequency of sicca symptoms (P = 0.001) and higher titers of ANA (>or=1:320) (P = 0.006) than the remaining 42 TN patients without CTD diagnoses. Sixteen patients had isolated laboratory or clinical abnormalities, and none of them had CTD diagnoses.
CONCLUSIONS: The concomitant presence of sicca symptoms and high titer ANA are clues for the early investigation of rheumatic diseases in TN patients.
Authors:
Iana Souza Nascimento; Eloísa Bonfá; Jozélio Freire de Carvalho; Carla Gonçalves Saad; Margarete Borges Galhardo Vendramini; Manoel Jacobsen Teixeira; José Cláudio Marinho Nóbrega; Vilma Santos Trindade Viana
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases     Volume:  16     ISSN:  1536-7355     ISO Abbreviation:  J Clin Rheumatol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-27     Completed Date:  2010-12-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9518034     Medline TA:  J Clin Rheumatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  205-8     Citation Subset:  IM    
Affiliation:
Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, Hospital das Clínicas da, São Paulo, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Aged
Antibodies, Antinuclear / blood*
Biological Markers / blood
Case-Control Studies
Connective Tissue Diseases / diagnosis,  epidemiology*,  immunology*
Female
Humans
Lupus Erythematosus, Systemic / diagnosis,  epidemiology,  immunology
Male
Middle Aged
Raynaud Disease / diagnosis,  epidemiology,  immunology
Risk Factors
Scleroderma, Systemic / diagnosis,  epidemiology,  immunology
Sjogren's Syndrome / diagnosis,  epidemiology,  immunology
Trigeminal Neuralgia / blood,  complications*,  immunology
Chemical
Reg. No./Substance:
0/Antibodies, Antinuclear; 0/Biological Markers

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