一个患有微细胞贫血的VEXAS病例:不要被相关疾病误导!
Kenza Squalli1, Louis Wolff1, Frédéric Vandergheynst1
1Department of Internal Medicine, Hôpitaux Universitaires de Bruxelles, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
Acta clinica Belgica
|September 16, 2024
概括
维克萨斯综合征通常伴有宏细胞贫血,但这种病例突出显示了维克萨斯综合征和沙拉西米亚患者的微细胞贫血. 微细胞性贫血不应该排除维克萨斯综合征的诊断.
科学领域:
- 类风湿病学 类风湿病学
- 血液学 血液学 血液学
- 遗传学 遗传学 是一个
背景情况:
- 维克萨斯综合征涉及类风湿和血液学问题,通常与骨髓质疏松综合征和巨细胞贫血有关.
- 典型的呈现包括宏细胞性贫血,但异常呈现也可能发生.
研究的目的:
- 报告一个出现微细胞贫血的VEXAS综合征病例.
- 讨论维克萨斯综合征中微细胞贫血的诊断含义,特别是在患有血病等并存疾病的患者中.
主要方法:
- 一个61岁的男性患有VEXAS综合征的病例报告.
- 诊断工作包括血红蛋白电泳,骨髓吸收和对UBA1突变的基因检测.
- 治疗涉及低剂量类固醇和沙利卢马布.
主要成果:
- 患者出现了微细胞性贫血,皮肤病变,发烧,体重减轻,静脉血栓,多关节炎和肺结节.
- 血红蛋白电泳揭示了轻微的β-thalassemia,有助于微细胞性贫血.
- 骨髓显示了真空化前体和三线化形,导致VEXAS综合征诊断得到了UBA1 p.M41T突变的证实.
- 治疗导致暂时的部分缓解.
结论:
- 微细胞贫血,即使与同时存在的血病,也不应排除考虑VEXAS综合征.
- 这一案例强调了在患者中考虑VEXAS综合征的重要性,这些患者有不明原因的全身炎症和血液学异常,无论贫血类型如何.
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