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Introduction Many times throughout our lives we have idols, people you admire and put on a pedestal, so the untouchable and we believe that nothing can happen, but when something happens that we are ordinary people, flesh and blood, and so are we.


General Information


Performance


Venus came into this U.S. Open ranked 2011 as the number 36, that in terms of ranking, so we had to play first round that normally do not play top-ranked players.


Recent titles won by Venus have been to Dubai in 2009 and Acapulco in 2010, tournaments that are highly relevant and competitive sports.


VIDEO


Symptoms reported by Venus


No matter how hard I trained, I never had stamina

http://www.youtube.com/watch?v=IrVknOd581A


I can not get in shape

http://www.youtube.com/watch?v=rT6GSnBOo80


four years ago, I felt like I was not getting enough air but I was diagnosed with exercise-induced astma http://www.youtube.com/watch?v=wZQjrYHrMAY


Joints pain, my hands started swelling, my joints started to kinda change shape http://www.youtube.com/watch?v=lhG2TC0xNXc


I had some of the classic symptoms, dry eyes and dry mouth.

http://www.youtube.com/watch?v=EYVd5mSVzHM


I lost a lot of feel. Like, I would miss shots by feet and I just couldn’t feel my hands, and my hands would hurt when I was playing.

http://www.youtube.com/watch?v=knCsOtjOMNM


I had swelling and numbness

http://www.youtube.com/watch?v=ZP1qMvyDJ5k


then fatigue which is really debilitating.

http://www.youtube.com/watch?v=oMpXo4b9rlQ


It's not that you have no energy – you just feel beat up

http://www.youtube.com/watch?v=wPQNzB3CbgM


I had a tough practice, I was just sitting there and it was taking an effort just to lift my arms http://www.youtube.com/watch?v=fV_1wjxlvcI


if you wake every morni ng and feel you have a cold but you do not have one http://www.youtube.com/watch?v=KVEL_eZoHqU


• 1. Shortness of breath (4 years ago) • 2. Joint pain in hands associated with swelling, inflammation and deformity • 3. Weakness to lift arms • 4. Fatigue, tiredness, and refers ‘she feel like she had a cold’  • 5. Sjogren's classic symptoms: mouth and dry eyes


Media reports


Media reports


Are the respiratory problems of Venus associated with pulmonary fibrosis secondary to Sjogren? •As described above it is possible to say that though Venus Williams comments that she was presenting respiratory difficulty, we do not believe that it is because a pulmonary fibrosis secundary to Sjogren, since the course of the disease has not been so chronic in her, we think that it is possible it is beacuse of the asthma induced by exercise, which was diagnosed 4 years ago, of course,we affirm this with the little information we have about the case, because of that information we can`t say she really has asthma. So it would be necessary to perform more complex tests to reject the presence fibrosis, that maybe is making a debut as atypical form


Differential diagnoses Rheumatoid arthritis • Evolution time (> 6 weeks), pain, inflammation and swelling in his hands anddeformity. • Although there is no serological results • View ACR criteria for RA according to 2010

INFORMATION LINK


Chronic Fatigue Syndrome. • A person with fatigue of more than six months of duration, but that has not suffered it for the whole life, does not associate it with the exercise, does not get better with the rest, has produced a substantial reduction to him or her in his/her daily activities and it is not possible to make clear for medical or psychiatric known reasons and that presents in addition four or any more of the following symptoms or signs: • 1. Disorders of the memory or of the concentration • 2.Odinophagia • 3. Axilar or cervical adenophaties • 4.Osteomuscular pain. • 5. Articular pain. • 6.Headache of recent appearance. • 7. Not repairer sleep • 8. Post-exercise aches


• Of which Venus has presented substantial reduction in her daily activities and can not be explained by known medical or psychiatric causes, osteomuscular pains, articular pains, not repairer sleep and post- exercise aches.

INFORMATION LINK


Fibromyalgia • Fibromyalgia is a common disease characterized by widespread musculoskeletal pain, stiffness, paresthesias, sleep disturbances and fatigue, painful sites and numerous large and symmetrical distribution. It is more common in women than in men, with a ratio of 9 to 1. The disease exists in almost all countries, the majority of ethnic groups and in all weather. Its prevalence in the general population of an American community under the 1990 classification criteria of the American College of Rheumatology is 3.4% in women and in men 0.55. Most patients are between 30 and 50 years of age.


• Clinical: Symptoms are characterized by widespread musculoskeletal pain, stiffness and fatigue. Patient sometimes complains of joint pain and joint swelling seen, but on physical examination abnormalities are not observed. The stiffness is almost always in the morning when you wake up and improve over the course of hours but in some cases persists throughout the day. Many patients complain of numbness in hands and feet and many are tired and exhausted since they are awake. In many cases, anxiety, or depression

INFORMATION LINK


• The symptoms reported by Venus Williams are related to fibromyalgia include: • musculoskeletal pain • Fatigue • joint pain • Hand Numbness • anxiety

INFORMATION LINK


Polymyositis • The polymyositis is a connective tissue disease characterized by the presence of muscular weakness of predominance proximal, in the escapular waist and pelvic, the respiratory muscles, of the swallowing and the myocardium.


• With regard to Venus we observe that she presents the muscular weakness, which we it see reflected in that she cannot lift the arms. • Also she presents artralgias. • Although she also feels pain, and dry eyes and dry mouth, these are not characteristic of the disease.

INFORMATION LINK


驴Se debi贸 retirar Venus del Tenis?


¿Regresará Venus al Tenis?


Other testimonies At 53 years, Jenny Inga, president of the " Spanish Association of Sjรถgren Syndrome ', acknowledges that it is a fairly common disorder, although with different manifestations depending on the patient. "It's very prevalent, but not all have the same degree of severity. People who only suffer from impairment in the eyes and mouth are often seen in primary care, the most serious cases are referred to hospital."


• Victòria Espiniella, president of the 'Catalan Association of Sjögren Syndrome', in getting it diagnosed. "The average time to achieve a medical opinion is between six and eight years. In my case, they were eight. It all started one day in which, literally closed my eyes and could not open them. I went to the eye but treatments failed to overcome the problem. Any external agent hurts me. Gradually, the problem got worse until it affects the throat and started the muscle aches, tiredness and fatigue. "


CONCLUSION Analyzing the case of Venus Williams, recording each and every one of the symptoms expressed by her, and addressing the study and the relationship of these as described in the literature, we conclude that differential diagnosis and surplus (rheumatoid arthritis, SLE, secondary Sjogren's syndrome, fibromyalgia, polymyositis, chronic fatigue syndrome), but a definitive diagnosis is impossible to give without laboratories and related studies and even more when there is little information about the onset of symptoms presented by Venus. What is clear is that the established approach is sound and that would be by check which of these diagnoses is that which corresponds in this case, all the while possible and we have key data that we analyze, discuss and complete data, which unfortunately are not yet within our reach.


Bibliography : • • • • • • • • • • •

http://books.google.com.co/books?id=o83v2ocK80IC&pg=PA471&lpg=PA471&dq=sindrome+sjogren+d http://www.cieph.com.br/site_novo/downloads/Livros/Sindrome%20de%20Sjogren%20en%20espanol . http://www.elmundo.es/elmundosalud/2011/09/01/noticias/1314888547.html http://www.cieph.com.br/site_novo/downloads/Livros/Sindrome%20de%20Sjogren%20en%20espanol http://www.niams.nih.gov/Portal_en_espanol/Informacion_de_salud/Sindrome_de_Sjogren/default.asp http://www.encolombia.com/medicina/reumatologia/reuma82-01-manifestacionesis.htm http://www.doctorponce.com/modules.php?name=Sections&op=viewarticle&artid=40 http://www.bbc.co.uk/mundo/ultimas_noticias/2011/09/110901_ultnot_eeuu_tenis_venus_williams_en aesjogren.org http://www.revistacolombianadereumatologia.org/Portals/0/Descargas/3-enfermedad%20quistica%209 http://www.medicalcriteria.com/site/index.php?option=com_content&view=article&id=211:reusjs&catid


Interviews

• http://www.youtube.com/watch?v=fsIfOLuCNRM • http://www.venustennis.com/interviews/usopen20071.h


Topic Information :

• http://www.sjogrens.org/home/about-sjogrens-syndrom • www.sjogrens-guidebook.com http://www.wtatennis.com/page/Player/Stats/0,,12781~ 27,00.html • http://www.elespectador.com/deportes/tenis/articulo-29 • http://es-us.deportes.yahoo.com/noticias/venus-williamshttp://vimeo.com/16671907


Venus Williams case /El caso de Venus Williams .  

Rheumatological approach to Venus Williams Case and Sjogrens Syndrome . A work presented by students to Dr Carlo V Caballero Uribe

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