甲状腺疾病与ANCA相关的血管炎:一项临床和流行病学研究
Anna Wilding1, Rona Smith2,3, David Jayne4
1Clinical Sciences, Department of Nephrology, Skåne University Hospital, Lund University, Lund, Sweden anna.wilding@med.lu.se.
RMD open
|April 30, 2024
概括
甲状腺疾病 (TD) 是抗中性子细胞质抗体 (ANCA) 相关血管炎 (AAV) 的常见并发症,几乎影响五分之一的患者. 虽然TD在女性和MPO-ANCA+患者中更常见,但在AAV治疗开始后,它不会预测新的病例.
科学领域:
- 类风湿病学 类风湿病学
- 内分泌学 在内分泌学.
- 免疫学 免疫学 免疫学
背景情况:
- 反中性细胞质抗体 (ANCA) 相关的血管炎 (AAV) 是一组罕见的自身免疫性疾病.
- 甲状腺疾病 (TD) 在患有AAV的患者中可能是同时发生的疾病.
- 了解AAV和TD之间的关系对于患者管理至关重要.
研究的目的:
- 描述AAV和TD患者的临床和实验室特征.
- 为了确定AAV队列中TD的发病率和预测因素.
- 为了比较AAV患者与没有TD之间的结果.
主要方法:
- 来自瑞典和英国的两个大型AAV队列 (n=644) 的分析.
- 通过医疗记录审查确认AAV和TD诊断.
- 考克斯回归分析以确定TD发展的预测因素.
主要成果:
- 在AAV诊断时,15.5%的患者有先前存在的TD,MPO-ANCA+个体更常见.
- 患有TD的患者表现出较低的C-反应蛋白,血红蛋白和较少的宪法症状.
- 在AAV患者中,先前存在的TD的存活率和性存活率更高.
- 新出现的TD发病率为641/100,000人/年;没有任何因素预测其发病.
结论:
- 甲状腺疾病是AAV中常见的并发症,在近20%的患者中存在.
- 虽然TD在女性和MPO-ANCA+AAV患者中更为普遍,但这些因素并不能预测新发性TD.
- 在所有AAV患者中,无论最初的特征如何,都需要对TD进行持续监测.
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