探索儿童发作的全身性红斑狼中的胃肠道表现 - - 多中心研究的见解
Hafize Emine Sönmez1, Ezgi Deniz Batu2, Rana İşgüder3
1Faculty of Medicine, Department of Pediatric Rheumatology, Kocaeli University, Kocaeli, Turkey.
Lupus
|August 26, 2024
概括
胃肠道问题在儿童开始的全身性红斑狼 (SLE) 中很常见,在诊断时影响超过60%. 医生应考虑在患有胃肠道症状的儿童中考虑SLE,并评估儿科SLE患者的胃肠道参与.
科学领域:
- 儿科风湿病学 儿科风湿病学
- 胃肠病学 胃肠病学
- 自免疫性疾病 自免疫性疾病
背景情况:
- 系统性红斑狼 (SLE) 是一种自身免疫性疾病,可以影响多个器官系统.
- 胃肠道系统 (GIS) 的参与是SLE患者中已知的,但往往未被确诊的并发症.
- 儿童发病的SLE (cSLE) 在诊断和管理方面提出了独特的挑战,包括非典型的表现.
研究的目的:
- 评估诊断为SLE的儿童中胃肠道 (GI) 症状的患病率和特征.
- 为了确定与SLE诊断相对的肠道干预的时间.
- 区分与SLE相关的胃肠道问题,药物副作用和并发症.
主要方法:
- 一组123名患有童年发病的SLE和确认的GIS参与的患者在16个儿科风湿病中心进行了研究.
- 所有参与者都符合SLE诊断的系统性狼国际合作诊所 (SLICC) 标准.
- 数据收集包括临床症状,实验室发现和GIS参与的诊断评估.
主要成果:
- 78名 (63.4%) 患者在最初的SLE诊断时存在胃肠道干扰,其中45名 (36.6%) 患者后来出现了症状.
- 腹部疼痛 (62.6%),肝转氨酶水平升高 (56.9%) 和肝 (32.5%) 是最常见的最初的胃肠道症状.
- 在78.6%的病例中,GIS的参与被归因于SLE,在28.5%的病例中,药物不良反应被归因于SLE,在0.5%的病例中,伴随性疾病被归因于SLE.
结论:
- 胃肠道干扰是儿童发病的SLE的一个重要特征,在所有受影响的儿童中都需要考虑.
- 儿科SLE应纳入儿童的差异诊断中,这些儿童呈现出无法解释的胃肠道症状,特别是那些肝酶升高的儿童.
- 临床医生必须区分与SLE相关的胃肠道病理,药物诱导的并发症以及在治疗cSLE患者中的其他促成因素.
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