Arthritis Rheumatol:抗中性粒细胞胞浆抗体相关性血管炎的皮肤表现

2020-05-21 xiangting MedSci原创

皮肤表现在AAV中很常见且有差异。在GAV、EGPA、胞浆/抗PR3 ANCA阳性或ANCA阴性患者中,皮肤表现与疾病严重程度相关。

抗中性粒细胞胞浆抗体相关性血管炎(AAV)的皮肤表现未得到良好的表征,其中包括肉芽肿合并多血管炎(GPA)、显微镜下多血管炎(MPA)和嗜酸性肉芽肿合并多血管炎(EGPA)。这项研究描述了AAV的皮肤病学特征及其与血管炎全身表现的关联。

这是一项横断面研究,描述和比较了AAV的皮肤表现,数据来自一项收集有关血管炎患者全面临床数据的大型国际协作研究。

来自全球130个中心1184例AAV患者的数据可用于研究。在所有AAV亚型中皮肤表现都很常见:GPA(223/656; 34%),MPA(85/302; 28%)和EGPA(106/226; 47%)。AAV(所有类型)中最常见的皮肤表现是瘀斑/紫癜(N=181;15%)。变应性和非特异性表现,例如瘙痒、荨麻疹和斑丘疹在EGPA中比其他亚型更常见(p均<0.01)。皮肤活检虽然使用率不高(占22-44%),但通常具有诊断意义(68-94%)。

与没有皮肤表现的患者相比,有皮肤病变的患者中严重全身性血管炎的表现更常见(例如肺泡出血和肾小球肾炎),尤其是GPA或EGPA患者,和胞浆/抗PR-3 ANCA阳性或ANCA阴性患者(危险比均≥1.9),但MPA或核周/抗MPO ANCA阳性患者除外。

皮肤表现在AAV中很常见且有差异。在GAV、EGPA、胞浆/抗PR3 ANCA阳性或ANCA阴性患者中,皮肤表现与疾病严重程度相关。这些发现强调了皮肤检查在AAV评估和治疗中的潜在诊断和预后重要性。

原始出处:

Robert G Micheletti. Cutaneous manifestations of anti‐neutrophil cytoplasmic antibody‐associated vasculitis. Arthritis Rheumatol.18 May 2020.

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    2020-05-23 zhaojie88
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