自体免疫多面体综合征1型儿童症状的临床、免疫和分子基因描述:一系列病例

О. И. Краснопёрова, Елена Николаевна Смирнова, Г. В. Чистоусова
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引用次数: 0

摘要

自身免疫性多腺综合征1型的临床多态性、非典型形式的存在以及靶器官疾病的潜伏期长,决定了该病的诊断困难,导致危及生命的疾病发现较晚,治疗不足。本文回顾性分析了2006年至2016年住院的7例1型自身免疫性多腺综合征患儿的临床资料。临床表现为慢性念珠菌病(7例)、甲状旁腺功能减退(6例)、慢性肾上腺功能不全(3例)、自身免疫性肝炎(3例)。临床表现不典型(环状红斑、牙釉质发育不全、涎腺炎)。所有患儿干扰素抗体滴度均较高(6个标准),干扰素2抗体为4个标准。在所有慢性肾上腺功能不全和自身免疫性肝炎病例中,相应的抗体均检测到高滴度(2个标准)。临床多态性、单症状病程延长、证候首发潜伏期延长,需要现代免疫学诊断方法和靶器官残余功能监测,及时启动治疗,预防危象状态。
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Клиническое, иммунологическое и молекулярно-генетическое описание симптомов у детей с аутоиммунным полигландулярным синдромом 1-го типа: описание серии случаев
Clinical polymorphism of autoimmune polyglandular syndrome type 1, the presence of atypical forms and a long latent period of the target organ disease determine the difficulties in diagnosing this disease, which leads to late detection of life-threatening conditions and inadequate treatment of such patients. The article presents the results from a retrospective analysis of 7 clinical cases of autoimmune polyglandular syndrome type 1 in children hospitalized between 2006 and 2016. The clinical manifestations of the syndrome included chronic candidiasis (7 patients), hypoparathyroidism (6), chronic adrenal insufficiency (3), and autoimmune hepatitis (3). The atypical clinical signs of the disease (annular erythema, hypoplasia of tooth enamel, sialadenitis) were revealed. All children had high ( 6 norms) antibody titers to interferon , 4 — antibodies to interferon 2. In all cases of chronic adrenal insufficiency and autoimmune hepatitis, the corresponding antibodies were determined in high ( 2 norms) titers. Clinical polymorphism, prolonged monosymptomatic course, prolonged latent period between the debuts of the syndrome manifestations require modern immunological methods of diagnostics and monitoring of the residual function of the target organ for the timely initiation of therapy and prevention of crisis states.
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