在接受异性干细胞移植的VEXAS患者中感染
Megan Biggs1, Patrick Crowley1, Matthew Thoendel1
1Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA.
概括
接受血造干细胞移植 (HSCT) 的VEXAS综合征患者面临高感染风险,特别是细菌性感染,如细菌病,即使有预防措施. 对感染的警在这个免疫力低下的群体中至关重要.
科学领域:
- 免疫学 免疫学 免疫学
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
背景情况:
- 维克萨斯 (VEXAS) (Vakuoles,E1酶,X链接,自身炎症,体质) 是一种新兴的自身炎症综合征,与UBA1.1体质突变相关.
- 造血干细胞移植 (HSCT) 是越来越多地用于治疗VEXAS综合征的治疗方法,创造了感染的高风险人群.
- 关于VEXAS患者在HSCT后感染的频谱和发病率的数据有限.
研究的目的:
- 为了研究HSCT后患有VEXAS综合征的成年患者感染的发生率和类型.
- 评估这一群体中预防感染的预防措施的有效性.
- 在接受HSCT的VEXAS患者的感染监测和管理方面为临床实践提供信息.
主要方法:
- 对十名被诊断患有VEXAS综合征的成年患者进行了回顾性审查.
- 参与该研究的患者曾在梅奥诊所罗切斯特或亚利桑那州医疗记录系统中接受过HSCT.
- 分析了有关感染类型,时间和结果的数据.
主要成果:
- 十分之九的患者 (90%) 在HSCT后出现细菌感染.
- 其中8名患者 (80%) 患有细菌病,尽管接受了预防性抗生素.
- 病毒感染发生在6名患者中 (60%),而没有记录入侵性真菌感染. 一名患者患有寄生虫感染.
结论:
- 细菌感染,包括细菌病,在VEXAS患者中非常普遍,无论预防措施如何.
- 医疗保健提供者必须保持高的感染怀疑指数,特别是细菌,在这个免疫受损的人群中.
- 对于早期检测和管理,患者对识别感染迹象和症状的教育至关重要.
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