(重述。复发polychondritis]。

Q4 Medicine Revue Du Praticien Pub Date : 2023-05-01
Philippe Mertz, Laurent Arnaud
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引用次数: 0

摘要

复发POLYCHONDRITIS。复发性多软骨炎(RP)是一种全身性疾病,仅在1/3的病例中诊断依赖于疾病开始时典型软骨炎的存在。RP的三种表型已经被描述,每一种都有特定的表现和需要特定的治疗管理和随访。如果怀疑RP,必须系统地筛查气管支气管表现,因为它是该疾病的大部分发病率和死亡率的原因。筛查UBA1突变是否存在于VEXAS综合征(液泡、E1酶、x连锁、自身炎症、体)是50岁以上大细胞性贫血男性患者的关键,特别是在皮肤或肺部表现或血栓栓塞并发症的情况下。最初的筛查可以排除主要的鉴别诊断(anca相关的血管炎),并寻找相关的自身免疫性或炎症性疾病,这些疾病在30%的病例中存在。RP的治疗管理尚未编纂,并取决于疾病的严重程度。
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[Restatement. Relapsing polychondritis].

RELAPSING POLYCHONDRITIS. Relapsing polychondritis (RP) is a systemic disease which diagnosis relies on the existence of typical chondritis present at the beginning of the disease only in 1/3 of cases. Three phenotypes of RP have been described, each one characterized by specific manifestations and the need of a specific therapeutic management and follow-up. Screening for tracheo-bronchial manifestations must be systematic if RP is suspected, as it is responsible for most of the morbi-mortality of the disease. Screening for the presence of UBA1 mutations for VEXAS syndrome (Vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) is key in male patients over 50 years-old presenting with macrocytic anemia, especially also in case of dermatologic or pulmonary manifestations or thrombo-embolic complications. Initial screening allow to rule-out the main differential diagnosis (ANCA-associates vasculitis) and to look for associated auto-immune or inflammatory diseases which are present in 30% of cases. Therapeutic management of RP is yet to be codified and depends on the severity of the disease.

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来源期刊
Revue Du Praticien
Revue Du Praticien Medicine-Medicine (all)
CiteScore
0.20
自引率
0.00%
发文量
161
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