在加拿大诊断和管理杆细胞激活综合征 (MCAS):一个实用的方法
Erika Lee1,2,3, Matthieu Picard4,5,6
1Division of Allergy and Clinical Immunology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
概括
巨细胞激活综合征 (MCAS) 诊断包括评估症状,排除次要原因,并确认巨细胞激活. 管理包括急性治疗和预防性治疗持续症状.
科学领域:
- 过敏和免疫学 过敏和免疫学
- 巨细胞疾病 巨细胞疾病
- 内部医学 内部医学
背景情况:
- 乳腺细胞激活综合征 (MCAS) 越来越多地在患有不明原因的多系统症状的患者中被识别出来.
- 对于这种复杂的疾病,需要诊断和管理指南.
研究的目的:
- 提供基于国际共识标准的MCAS诊断和管理的实用,逐步方法.
- 为指导临床医生评估疑似MCAS和持续症状的患者.
主要方法:
- 审查来自欧洲瘤细胞瘤能力网络的共识标准 - 美国瘤细胞疾病倡议.
- 一步一步的诊断方法:临床表现评估,排除二次原因,对瘤细胞激活的客观证据.
- 在特定情况下对克隆性干细胞疾病的评估 (例如,异常性过敏反应).
主要成果:
- 诊断MCAS需要严重的,涉及至少两个器官系统的插曲性症状,与巨细胞激活一致.
- 排除NSAID过敏和依赖辅因子的食物过敏等二次原因至关重要.
- 客观证据可以包括事件后血清三酶或尿中介代谢物的急性增加.
结论:
- 一种结构化的方法有助于MCAS的诊断和管理.
- 治疗包括急性发作管理 (上腺素) 和预防疗法 (抗胰岛素,根据需要升级).
- 需要进一步的研究和改善对诊断工具的访问,以完善护理.
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