在多肌痛性风湿症中是否存在明确的疾病子组? 来自叙事复习的建议
Paolo Falsetti1, Ciro Manzo2, Marco Isetta3
1Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy.
Healthcare (Basel, Switzerland)
|June 13, 2025
概括
这项研究确定了多发性肌痛性风湿症 (PMR) 的七个子集,区分真实的PMR和模仿条件. 结果有助于准确诊断,影响PMR患者的治疗和健康政策.
科学领域:
- 类风湿病学 类风湿病学
- 内部医学 内部医学
- 临床免疫学临床免疫学
背景情况:
- 多发性肌痛性风湿症 (PMR) 呈现出多种发病和病程,使得与多发性肌痛综合征的差异化具有挑战性.
- 识别不同的PMR子集对于准确的诊断,治疗,预后和健康政策制定至关重要.
- 区分真正的PMR和模仿PMR的疾病需要仔细的临床评估.
研究的目的:
- 在科学文献中识别和描述多发性肌痛类风湿症 (PMR) 的不同子集或集群.
- 描述PMR子集,支持至少两项独立研究的发现.
- 为了区分真正的PMR子集和模仿PMR条件.
主要方法:
- 在Embase和Medline上进行了非系统的文献搜索,使用与PMR,子集,模拟条件和潜在触发器相关的关键词.
- 扫描了相关文章的参考列表,以寻找其他出版物.
- 进行了对103篇文章的全面审查,其中84篇被评估是否符合资格.
主要成果:
- 确定了七个主要的PMR子集:正常的急性阶段反应物,感染触发物,疫苗接种触发物,亚临床巨细胞动脉炎 (GCA),酸盐沉积疾病 (CPPD),与免疫检查点抑制剂 (ICI) 治疗相关的和特殊的临床集群.
- 具有正常急性相反应物的PMR和因感染或疫苗接种引发的PMR被认为是不同的疾病子集.
- 带有亚临床GCA的PMR和大多数PMR/CPPD病例被归类为PMR模仿者.
结论:
- 具有正常基线急性相反应物的PMR和因感染或疫苗接种引发的PMR代表了有效的疾病子集.
- 与亚临床GCA和CPPD相关的PMR在很大程度上被认为是PMR模仿者.
- 需要进一步的研究来澄清特殊的临床子集和ICI诱导的PMR.
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