Rev. Rom de STOMATOLOGIE nr.1 - 2007.p65 - medica.ro

22 REVISTA ROMÂNÅ DE <strong>STOMATOLOGIE</strong> – VOL. LIII, NR. 1, AN 2007
„Carol Davila“ University of Medicine and
Pharmacy, Bucharest
Background
Sjögren’s Syndrome (SS) is one of the most
frequent but un<strong>de</strong>rdiagnosed autoimmune disor<strong>de</strong>rs,
which affects approximately 1% of the population.
The main target of this disease is the exocrine
glands that are infiltrated progressively by
lymphocytes leading to <strong>de</strong>creased exocrine secretion.
The most serious complication of SS is the
high risk of the occurrence of non-Hodgkin’s
Lymphoma (nHL).
Objectives
To evaluate the characteristics of the patients
with Sjögren’s Syndrome who <strong>de</strong>velop non-
Hodgkin’s Lymphoma.
Methods
We studied retrospectively the data of 64 patients
(98% females of ages between 32 and 74
years old, median age 52) with SS who were
followed up in our clinic between 1996 and 2006.
The patients with primary SS (18-35.3%) had to
fulfill the European-American consensus group
criteria. The diagnosis of nHL was <strong>de</strong>monstrated
by histological studies.
Results
Four patients (6.25%), all females between 54
and 62 years old, <strong>de</strong>veloped lymphomas. The
average time of <strong>de</strong>velopment of malignancy was
8.6 years. The patients had severe xerophtalmia
and xerostomia, recurrent parotid swelling and
Raynaud’s phenomenon. Two of them had vasculitis
(leg ulcers, palpable purpura) and one
splenomegaly. All theese patients received high
doses of immunosuppressive treatment for more
than 5 years. The frequency of abnormal laboratory
findings was as follows: 100% had high levels
of ESR (>80mm/h) and anemia, 66% had crioglobulinaemia
and low levels of complement. All had
high levels of antibodies to Ro/SS-A and La/SS-B.
In one case we i<strong>de</strong>ntified the loss of the previously
positive rheumatoid factor. The lymphomas <strong>de</strong>veloped
in nodal sites in two patients and in submandibular
salivary glands in one patient. The
histological type was Marginal Zone B-cell
Lymphoma. Three of the patients had a very good
response to radiotherapy. One patient, with stage
III and group B symptoms (fever, malaise, ano-
rexia) when diagnosed, nee<strong>de</strong>d chemotherapy.
Despite the treatment she had the recidiva of malignancy
with an evolution to high-gra<strong>de</strong> lymphoma.
She had also chronic infection with Ebstein-
Barr virus.
Conclusion
Patients with SS must be closely followed up
for the <strong>de</strong>velopment of non-Hodgkin’s Lymphoma.
This retrospective analysis confirmed at our
patients that there are some clinical and laboratory
predictive factors. High doses of immunosuppressive
therapy might pay a role in the occurrence
of the malignancy.
CERCETÅRI ASUPRA GLUCOZAMIN-
GLICANILOR DIN EPITELIUL GINGIVAL LA
COPII
Prof. Univ. Dr. Ovidiu Grivu, Dr. Adrian Faur,
Dr. Simona Mereanu, Dr. Anca Porumb
Sec¡ia <strong>de</strong> medicinå <strong>de</strong>ntarå a Universitå¡ii
<strong>de</strong> Vest „Vasile Goldi¿“ Arad ¿i
Facultatea <strong>de</strong> Medicinå Dentarå din Ora<strong>de</strong>a
Rezumat
Scopul lucrårii: Studierea componentei glucozamin-glicanice
din epiteliul gingival al copiilor.
Material ¿i metodå
15 biopsii <strong>de</strong> mucoaså gingivalå <strong>de</strong> la subiec¡i
cu vârsta între 6 ¿i 15 ani.
Fragmentele recoltate au fost fixate, incluse în
parafinå, sec¡ionate la 5 microni ¿i colorate cu:
– colora¡ia bicromå hematoxilinå-eosinå
(HE);
– reac¡ia PAS;
– reac¡ia salivå-PAS;
– colora¡ia cu albastru alcian – PAS;
– colora¡ia cu permanganat <strong>de</strong> potasiu-albastru
alcian în mediu <strong>de</strong> acid acetic;
– colora¡ia albastru policrom-tanin (ATP);
– colora¡ia cu albastru <strong>de</strong> toluidinå.
Rezultate
Colora¡ia APT-Drågan aratå o reac¡ie metacromaticå
difuzå mo<strong>de</strong>ratå, inconstantå, în stratul
spinos. Metacromazia APT-pozitivå råmâne persistentå
doar în stratul paracheratotic. Reac¡ia PAS
este inteså la nivelul stratului spinos superior cu
celule pavimentoase ¿i nuclei prepicnotici
(SPNPP)