EXAS 综合征:即将改变人们对已知疾病的看法

B. D. Chaltsev, A. Torgashina, A. Lila, T. Markova, S. I. Kutsev, O. Ryzhkova, A. Orlova, A. Kokhno, T. I. Solovyova, V. Dvirnyk, A. Kovrigina, T. Obukhova, E. N. Parovichnikova, E. Nasonov
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摘要

本文介绍了在俄罗斯联邦发现的首例 VEXAS 综合征病例,以及目前已知的临床表现和治疗方法的特点。所描述的临床观察是一个令人印象深刻的例子,说明新的致病基因突变的发现如何改变人们对以前已知的免疫炎症性疾病的分类、诊断和治疗的认识。因此,对于难治性复发性多软骨炎、嗜中性粒细胞皮肤病、非典型血管炎、炎性关节病或未分化系统性炎症综合征,尤其是伴有巨幼红细胞性贫血和骨髓增生异常综合征时,应怀疑VEXAS综合征,并进行基因检测以排除现有疾病的自身炎症性质。
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EXAS syndrome: on the threshold of changing perceptions of known diseases
This article presents the first case of VEXAS syndrome identified in the Russian Federation as well as characteristics of currently known clinical manifestations and treatment approaches. The clinical observation described is an impressive example of how the identification of a new pathogenic mutation can change the understanding of the classification, diagnosis and treatment of previously known immunoinflammatory diseases. Thus, in refractory forms of relapsing polychondritis, neutrophilic dermatosis, atypical forms of vasculitis, inflammatory joint diseases or undifferentiated systemic inflammatory syndrome, especially when associated with macrocytic anemia and myelodysplastic syndrome, VEXAS syndrome should be suspected and genetic testing should be performed to exclude the autoinflammatory nature of the existing condition.
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