Olfactory function in systemic lupus erythematosus and systemic sclerosis. A longitudinal study and review of the literature

Publication date: Available online 11 February 2018
Source:Autoimmunity Reviews
Author(s): Mariana Freschi Bombini, Fernando Augusto Peres, Aline Tamires Lapa, Nailú Angélica Sinicato, Beatriz Ricato Quental, Ágatha de Souza Melo Pincelli, Tiago Nardi Amaral, Caroline Cristina Gomes, Ana Paula del Rio, João Francisco Marques-Neto, Lilian T.L. Costallat, Paula Teixeira Fernandes, Fernando Cendes, Leticia Rittner, Simone Appenzeller
Background/PurposeTo evaluate olfactory function in systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and healthy controls over a 2-year period, and to determine the association of olfactory dysfunction with age, disease activity, disease damage, treatment, anxiety and depression symptoms and limbic structures volumes.MethodsConsecutive SLE and SSc patients were enrolled in this study. Clinical, laboratory disease activity and damage were assessed according to diseases specific guidelines. Olfactory functions were evaluated using the Sniffin' Sticks test (TDI). Volumetric magnetic resonance imaging (MRI) were obtained in a 3T Phillips scanner. Amygdalae and hippocampi volumes were analyzed using FreeSurfer® software.ResultsWe included 143 SLE, 57 SSc and 166 healthy volunteers. Olfactory dysfunction was observed in 78 (54.5%) SLE, 35 (59.3%) SSc patients and in 24 (14.45%) controls (p<0.001) at study entry. SLE and SSc patients had significantly lower mean in all three phases (TDI) of the olfactory assessment when compared with healthy volunteers. In SLE, the presence of olfactory dysfunction was associated with older age, disease activity, higher anxiety and depression symptoms score, smaller left hippocampus volume, smaller left and right amygdalae volume and the presence of anti-ribosomal P (anti-P) antibodies. In SSc the presence of olfactory impairment was associated with older age, disease activity, smaller left and right hippocampi volumes and smaller right amygdala volume. Olfactory function was repeated after a 2-year period in 90 SLE, 35 SSc and 62 controls and was stable in all three groups.ConclusionBoth SLE and SSc patients with longstanding disease had significant reduction in all stages of TDI that maintained stable over a 2-year period. Olfactory dysfunction was associated with age, inflammation and hippocampi and amygdalae volumes. In SLE, additional association with anti-P, anxiety and depression symptoms was observed.



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