与感染相关的 Vasculitides 发生感染
1Department of Clinical Immunology and Rheumatology, Manipal Hospital, Millers Road, Bangalore, India.
Best practice & research. Clinical rheumatology
|March 15, 2025
概括
感染可以模仿原发性系统性血管炎,表现出类似的症状,需要仔细诊断. 意识到这些模仿感染至关重要,以避免潜在的致命的免疫抑制患者.
科学领域:
- 类风湿病学 类风湿病学
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 感染可能与初级系统性血管炎 (PSV) 有临床和研究上的相似之处.
- 区分感染和PSV至关重要,因为感染患者的免疫抑制可能是致命的.
- 感染可能模仿小,中或大血管血管炎,并通过分子模仿诱导像抗中性粒细胞体抗体 (ANCA) 这样的自身抗体.
研究的目的:
- 为了强调识别模仿血管炎的感染的重要性.
- 讨论感染可能导致或与血管炎相关的可能性.
- 在疑似血管炎病例中,向临床医生提供有关差异诊断的信息.
主要方法:
- 对临床表现和诊断挑战的审查,以区分感染与血管炎.
- 讨论感染相关血管炎的拟议病原遗传机制.
- 考虑血管炎的阴性原因,包括药物和免疫检查点抑制剂.
主要成果:
- 感染在PSV的临床特征和诊断发现中具有显著的重叠.
- 与COVID-19相关的血管炎是最近增加的感染模仿血管炎的频谱.
- 药物诱导的血管炎和免疫检查点抑制剂诱导的血管炎也是公认的实体.
结论:
- 临床医生必须保持高的感染怀疑指数,在出现血管炎类症状的患者中.
- 准确的诊断至关重要,以指导适当的治疗,并避免免疫抑制的不良结果.
- 血管炎的差异诊断应包括传染病因,药物反应和阳性原因.
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