[血管肽]。

IF 1.1 4区 医学 Q3 ANESTHESIOLOGY
Schmerz Pub Date : 2024-02-01 Epub Date: 2023-10-12 DOI:10.1007/s00482-023-00760-3
Thomas Rauen, Kristian Vogt, Stefan Krämer
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引用次数: 0

摘要

在日常临床实践中,免疫介导的系统性血管炎是罕见疾病之一,这意味着对主要症状和指示性实验室发现的基本知识对于将这些复杂的临床实体纳入鉴别诊断考虑至关重要。多年来,系统性血管炎一直根据主要受影响的血管大小进行分类,区分大、中、小血管。疼痛通常是这些疾病的主要症状之一,例如,巨细胞动脉炎的暂时性加重头痛,风湿性多肌痛的肩臀带清晨肌痛,或嗜酸性肉芽肿伴多血管炎的多发性单神经炎。发烧、体重减轻和盗汗等一般症状通常伴随着炎症参数的大幅增加。此外,器官特异性症状和/或实验室异常可能提供关键信息。这些症状包括耳鼻喉科症状、肺部或皮肤表现,以及肾脏受累的迹象,如外周水肿、血压升高、血尿、蛋白尿或肾功能迅速丧失。如果有合理的疾病怀疑,患者应该被转移到有跨学科团队的专业中心。在大多数情况下,需要免疫抑制治疗方案,尽管近年来,新疗法的使用为避免高剂量糖皮质激素和许多副作用铺平了道路。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

[Vasculitides].

[Vasculitides].

In everyday clinical practice, immunologically mediated systemic vasculitides are among the rare diseases, meaning that basic knowledge of major symptoms and indicative laboratory findings is crucial for the inclusion of these complex clinical entities in differential diagnostic considerations. For many years, systemic vasculitides have been classified according to the primarily affected vessel size, distinguishing large, medium-sized, and small vessels. Pain is very often one of the main complaints of these diseases, be it, for example, the temporally accentuated headache in giant cell arteritis, the early morning myalgias in the shoulder and hip girdle in polymyalgia rheumatica, or the mononeuritis multiplex in eosinophilic granulomatosis with polyangiitis. General symptoms such as fever, weight loss, and night sweats are often accompanied by greatly increased parameters of inflammation. In addition, organ-specific symptoms and/or laboratory abnormalities may provide crucial information. These include ENT symptoms, pulmonary or skin manifestations, as well as signs of renal involvement, such as peripheral edema, rise in blood pressure, hematuria, proteinuria, or a rapid loss of kidney function. If there is reasonable suspicion of disease, patients should be transferred to specialized centers with an interdisciplinary team. In most cases, an immunosuppressive therapy regimen is required, although in recent years the path towards avoiding high glucocorticoid doses with many side effects has been paved by the use of novel therapies.

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来源期刊
Schmerz
Schmerz 医学-临床神经学
CiteScore
2.00
自引率
20.00%
发文量
64
审稿时长
6-12 weeks
期刊介绍: Der Schmerz is an internationally recognized journal and addresses all scientists, practitioners and psychologists, dealing with the treatment of pain patients or working in pain research. The aim of the journal is to enhance the treatment of pain patients in the long run. Review articles provide an overview on selected topics and offer the reader a summary of current findings from all fields of pain research, pain management and pain symptom management. Freely submitted original papers allow the presentation of important clinical studies and serve the scientific exchange. Case reports feature interesting cases and aim at optimizing diagnostic and therapeutic strategies. Review articles under the rubric ''Continuing Medical Education'' present verified results of scientific research and their integration into daily practice.
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