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作 者:何璐(综述) 胡秀芬(审校)[1] HE Lu;HU Xiu-Fen(Department of Pediatrics,Tongji Hospital,Huazhong University of Science and Technology,Wuhan 430030,China)
机构地区:[1]华中科技大学同济医学院附属同济医院儿科,湖北武汉430030
出 处:《中国当代儿科杂志》2021年第10期1064-1068,共5页Chinese Journal of Contemporary Pediatrics
摘 要:幼年型皮肌炎(juvenile dermatomyositis,JDM)是以近端肌无力和皮疹为主要临床表现的自身免疫疾病,亦可累及多系统、多脏器。肌炎特异性抗体(myositis-specific autoantibodies,MSA)与JDM患者的并发症及预后高度相关。抗Mi-2抗体阳性患者预后较好,临床症状典型;抗MDA5抗体阳性患者多伴发弥漫性间质性肺疾病及皮肤溃疡,肌炎症状轻;抗NXP2抗体阳性患者易合并钙质沉着,该抗体与胃肠出血及穿孔相关;抗TIF1-γ抗体阳性患者有弥漫、顽固的皮损表现;抗SAE抗体在儿童中检出率较低,相关报道较少。该文综述了5种MSA亚型JDM患者的临床表型特点,为JDM患儿的临床治疗和随访管理提供依据。Juvenile dermatomyositis(JDM)is an autoimmune disease manifesting as proximal muscle weakness and skin rash and can involve multiple systems and visceral organs.Myositis-specific autoantibodies(MSAs)are highly associated with various complications and prognosis in JDM.Patients with anti-Mi-2 antibodies tend to have good prognosis and typical clinical symptoms.Patients with anti-MDA5 antibodies often have diffuse interstitial lung disease and skin ulcer,with mild symptoms of myositis.Patients with anti-NXP2 antibodies often have calcinosis,and such antibodies are associated with gastrointestinal bleeding and perforation.Patients with anti-TIF1-γantibodies have diffuse and refractory skin lesions.Anti-SAE antibodies are rarely detected in children,with few reports of such cases.This article reviews the features of clinical phenotypes in JDM children with these five types of MSAs,so as to provide a basis for the clinical treatment and follow-up management of children with JDM.
关 键 词:幼年型皮肌炎 血清学抗体 抗Mi-2抗体 抗MDA5抗体 抗NXP2抗体 抗TIF1-γ抗体 抗SAE抗体 临床表型 儿童
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