[VEXAS Syndrome].

La Revue du praticien Pub Date : 2025-02-01
Vincent Jachiet, Thibault Comont, Olivier Kosmider, Lin Pierre Zhao, Arsène Mekinian, Olivier Fain, Jérome Hadjadj
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Abstract

VEXAS SYNDROME. VEXAS (Vacuoles, E1 Enzyme, X-linked, Autoinflammatory, Somatic) syndrome is a recently described autoinflammatory syndrome, mostly affecting men above 50 years, caused by somatic mutation in the X-linked UBA1 gene. Patients present a broad spectrum of inflammatory manifestations (fever, neutrophilic dermatosis, chondritis, pulmonary infiltrates, ocular inflammation, venous thrombosis) with hematological involvement (macrocytic anemia, thrombocytopenia, vacuoles in myeloid and erythroid precursor cells, dysplastic bone marrow) which are responsible for significant morbidity and mortality. The therapeutic management is currently poorly codified, and based on two main approaches: controlling inflammatory symptoms by using corticosteroids, JAK inhibitors or tocilizumab, or targeting the UBA1-mutated hematopoietic population using azacitidine or allogeneic hematopoietic stem cell transplantation.

(VEXAS综合症)。
VEXAS综合症。VEXAS (Vacuoles, E1 Enzyme, X-linked, Autoinflammatory, Somatic)综合征是最近发现的一种自体炎症综合征,多见于50岁以上男性,由X-linked UBA1基因的体细胞突变引起。患者表现出广泛的炎症表现(发热、中性粒细胞皮肤病、软骨炎、肺部浸润、眼部炎症、静脉血栓形成),并伴有血液学受累性(巨细胞性贫血、血小板减少症、骨髓和红细胞前细胞空泡、骨髓发育不良),这些都是导致显著发病率和死亡率的原因。目前的治疗管理还不完善,主要基于两种方法:通过使用皮质类固醇、JAK抑制剂或tocilizumab来控制炎症症状,或使用阿扎胞苷或异基因造血干细胞移植靶向uba1突变的造血群体。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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