Prevalência de manifestações trombóticas nas doenças reumáticas imunomediadas: revisão sistemática

Abstract

The objective of this review was to evaluate the prevalence of thrombotic manifestations in patients with immune-mediated rheumatologic diseases.(IMRD). Introduction: IMRD in its nature generates a chronic recurrent inflammatory condition that can contribute to thrombogenesis. Antiphospholipid antibody syndrome (APS), when it develops after pre-established IMRD, is called secondary APS. There are many studies between systemic lupus erythematosus and APS, but other IMRD also have the ability to trigger secondary APS.Articles on systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Sjogren's syndrome (SS), vasculitis and systemic sclerosis (SSc) and their thrombotic manifestations were included in this review. Articles related to Covid-19, antiphospholipid antibody syndrome, pregnancy, use of biological medications, anticoagulants and peri and postoperative conditions were excluded. Pubmed (Medline), Scopus, Embase databases were searched between February and July 2022 with the help of a librarian to prepare the search terms. The selection and extraction was performed by three independent reviewers divided into 2 pairs, without time cut and without language restrictions. After the initial selection and application of the exclusion criteria, the articles that met the criteria for the diagnosis of FAS (Sapporo or Sidney), described in the literature, were extracted. Data were synthesized and evaluated using the JBI Sumari tool. In this review, 27 articles were included, 24 on SLE, 1 on RA, 1 on SS and 1 on vasc. The overall prevalence of thrombosis in the articles was 21% and the prevalence for each subgroup was 22% for SLE, 3.98% for RA, 18.8% for vasculitis and 7% for Sjögren's Syndrome. The prevalence of thrombosis in SLE was consistent with the literature. Thrombotic manifestations in IMRD are already well established in the literature, but the data are very focused on secondary APS associated with SLE, while in other ARMDs, there are few studies that relate thrombosis with secondary APS because they do not adequately follow the diagnostic criteria. defined for SAF.