Prevalência de doenças imunomediadas com manifestação oral no Laboratório de Patologia Cirúrgica da Universidade Federal do Amazonas: casuística de 45 anos

Abstract

Immune-mediated diseases constitute a heterogeneous group of conditions characterized by dysregulation of the immune response, potentially affecting multiple organs and systems, including skin and mucous membranes. Among their clinical manifestations, lesions in the oral cavity stand out, which, in some cases, represent initial or concomitant signs of systemic disease. These alterations present wide clinical variability and frequently nonspecific characteristics, making diagnosis challenging and dependent on the association between clinical evaluation, histopathological examinations, and complementary methods. The objective of this study was to describe the prevalence of immune-mediated diseases with oral manifestations and the sociodemographic, clinical, and histopathological profile of patients treated at a referral service over 45 years. The study design was observational, cross-sectional, retrospective, and documentary, and data collection was based on the analysis of histopathological reports and their respective annexes, obtained from biopsies of oral lesions performed between January 1980 and December 2024. Sociodemographic, clinical, and histopathological variables were considered. The study obtained 112 cases of immune-mediated diseases with oral manifestations, corresponding to 3.77% of the total oral cavity diseases (n=2,973) and 0.12% of the total reports analyzed during the period (n=93,438). A predominance of females (81.3%) was observed, and most cases occurred in middle-aged adults, especially between 41 and 50 years old (27.7%). Histopathological findings compatible with Sjögren's disease were the most prevalent (n=64; 57.1%), followed by oral lichen planus (n=22; 19.6%) and pemphigus vulgaris (n=9; 8.0%). The labial mucosa was the main affected site (n=67; 59.8%), followed by the tongue (n=16; 14.3%). It is concluded that immune-mediated diseases with oral manifestations are infrequent in the overall case series, exhibiting a sociodemographic profile consistent with a predominance in middle-aged women and preferential involvement of the labial, buccal, and lingual mucosa. Sjögren's disease was the most prevalent entity, followed by oral lichen planus and pemphigus vulgaris, frequently associated with comorbidities such as rheumatoid arthritis and systemic lupus erythematosus. The findings provide an unprecedented characterization of these pathologies in the State of Amazonas, highlighting the role of the dentist in early diagnosis and the need to improve the quality of local clinical records.Keywords: Autoimmune diseases; biopsy; prevalence; autoimmune; autoinflammatory.