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ISSN 0016-3813 (Impreso)

2016, Número 3

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Gac Med Mex 2016; 152 (3)


Síndrome de Sjögren (SS), revisión del tema y saliva como método diagnóstico

Riega-Torres JCL, Villarreal-Gonzalez AJ, Ceceñas-Falcon LÁ, Salas-Alanis JC

Idioma: Español
Referencias bibliográficas: 72
Paginas: 371-380
Archivo PDF: 224.02 Kb.


RESUMEN

El síndrome de Sjögren (SS) es una enfermedad autoinmune crónica cuya principal manifestación clínica es la sequedad oral (xerostomía) y ocular (xeroftalmia), se caracteriza por la infiltración mononuclear progresiva de las glándulas exocrinas y puede afectar una variedad de órganos y sistemas. La prevalencia del síndrome de Sjögren primario (SSp) varía desde el 0.01 hasta el 4.8%. Esta variabilidad refleja diferencias en la definición, aplicación de los criterios diagnósticos, diferencias geográficas y en los grupos de edad. La etiología del SSp es desconocida pero es importante la interacción entre factores genéticos y ambientales (virus, hormonas, vitaminas, estrés). Se han reportado pocos casos de concordancia en gemelos homocigotos y es común que los pacientes con SSp tengan familiares con otras enfermedades autoinmunes como lupus eritematoso diseminado (LES), artritis reumatoide (AR), enfermedad tiroidea, psoriasis y esclerosis múltiple. Dentro de los hallazgos más comunes está la hipergammaglobulinemia. Los niveles elevados de γ-globulinas contienen autoanticuerpos dirigidos contra antígenos no específicos como el factor reumatoide (FR), anticuerpos antinucleares (ANA), antígenos celulares SSA/Ro y SSB/La. En cuanto al diagnóstico ha habido 11 diferentes criterios publicados para SS desde 1965, ninguno ha sido aprobado por el Colegio Americano de Reumatología (ACR) o Liga Europea contra el Reumatismo (EULAR), los criterios actuales fueron publicados en 2012. Conjuntamente con el avance progresivo en el conocimiento del proteoma salival humano ha ganado gran aceptación en el SS la posibilidad de usar la saliva como una herramienta útil tanto en el campo diagnóstico como pronóstico, esto debido a que el análisis de las proteínas salivales puede reflejar localmente el estado patológico subyacente de las glándulas salivales, que son el órgano blanco en esta enfermedad.


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