严重指缺血是抗合成酶自身抗体患者未被识别的表现:病例系列和系统文献综述。

IF 1.4 Q3 RHEUMATOLOGY
Akira Yoshida, Takahisa Gono, Yuka Okazaki, Yuichiro Shirai, Mitsuhiro Takeno, Masataka Kuwana
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引用次数: 0

摘要

目的:严重的指部缺血,包括指部溃疡和坏疽,在具有抗合成酶抗体的患者中被认为是罕见的。本研究旨在通过系统的文献综述和单中心队列中的病例系列,阐明抗Synthetase阳性患者并发指溃疡和/或坏疽的临床特征。方法:进行系统的文献综述,以确定描述趾溃疡和/或坏疽的抗Synthetase阳性病例的报告。我们的连续抗合成酶抗体患者队列根据严重指部缺血史进行分层。将系统文献综述和我们的队列中确定的严重指部缺血患者的人口学和临床特征及结果与我们队列中没有严重指部缺血性的患者进行比较。结果:系统的文献回顾显示,从1个病例系列和8个病例报告中,有12例抗合成酶阳性的严重指部缺血患者。在我们的队列中,100名具有抗合成酶抗体的患者中有7名(7%)有严重指部缺血的记录。严重的指部缺血通常在出现时发现,并与系统性硬化的分类有关,有或没有肌炎重叠。抗Synthetase阳性患者与严重指部缺血相关的临床特征包括雷诺现象(p p = 0.001)和甲襞毛细血管异常(p = 0.02)。血管舒张剂对严重指部缺血的结果通常是有利的。结论:严重指部缺血是抗synthese阳性患者中一个被忽视的并发症。应在出现指溃疡或坏疽的患者中测量抗合成酶抗体,特别是在那些具有系统性硬化表型和在缺乏系统性硬化特异性自身抗体的情况下与抗合成酶抗体相关的特征的患者中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Severe digital ischemia as an unrecognized manifestation in patients with antisynthetase autoantibodies: Case series and systematic literature review.

Objective: Severe digital ischemia, including digital ulcers and gangrene, is considered rare in patients with antisynthetase antibodies. This study aimed to elucidate the clinical features of antisynthetase-positive patients complicated with digital ulcers and/or gangrene using a systematic literature review and case series in a single-center cohort.

Methods: A systematic literature review was conducted to identify reports describing antisynthetase-positive cases with digital ulcers and/or gangrene. Our cohort of consecutive patients with antisynthetase antibodies was stratified by the history of severe digital ischemia. Demographic and clinical features and outcomes in patients with severe digital ischemia identified in the systematic literature review and our cohort were compared with those in patients without severe digital ischemia in our cohort.

Results: The systematic literature review revealed 12 antisynthetase-positive patients with severe digital ischemia from one case series and eight case reports. Seven (7%) of 100 patients with antisynthetase antibodies in our cohort had a record of severe digital ischemia. Severe digital ischemia was often found at presentation and was associated with the classification of systemic sclerosis with or without myositis overlap. Clinical features associated with severe digital ischemia in antisynthetase-positive patients included Raynaud's phenomenon (p < 0.001), digital pitting scars (p = 0.001), and nailfold capillary abnormality (p = 0.02). Outcomes of severe digital ischemia were generally favorable with vasodilators.

Conclusion: Severe digital ischemia is an overlooked complication in antisynthetase-positive patients. Antisynthetase antibodies should be measured in patients presenting with digital ulcers or gangrene, especially in those with systemic sclerosis phenotype and features associated with antisynthetase antibodies in the absence of systemic sclerosis-specific autoantibodies.

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来源期刊
CiteScore
4.10
自引率
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