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局限性硬皮病患儿的眼部受累情况:一项多中心研究

Ocular involvement in children with localised scleroderma: a multi-centre study.

作者信息

Zannin Maria Elisabetta, Martini Giorgia, Athreya Balu H, Russo Ricardo, Higgins Gloria, Vittadello Fabio, Alpigiani Maria Giannina, Alessio Mariolina, Paradisi Mauro, Woo Patricia, Zulian Francesco

机构信息

Department of Pediatrics, Via Giustiniani 3, 35128 Padova, Italy.

出版信息

Br J Ophthalmol. 2007 Oct;91(10):1311-4. doi: 10.1136/bjo.2007.116038. Epub 2007 May 2.

Abstract

BACKGROUND

Most of the available documentation in the literature on ocular involvement in localised scleroderma (LS) are descriptions of single cases in adult patients. This article reports the frequency and specific features of ocular involvement in a large cohort of children with juvenile LS (JLS).

METHODS

Data from a large, multi-centre, multinational study of children with LS were used to collect and analyse specific information on ocular involvement.

RESULTS

24 out of 750 patients (3.2%) revealed a significant ocular involvement. 16 were female and 8 male. 16 patients (66.7%) had scleroderma "en coup de sabre" (ECDS) of the face, 5 (20.8%) had the linear subtype, 2 (8.3%) had generalised morphea (GM) and one (4.2%) had plaque morphea (PM). Of the 24 patients with eye involvement, 10 patients (41.7%) reported adnexa (eyelids and eyelashes) abnormalities, 7 (29.2%) anterior segment inflammation (5 anterior uveitis, 2 episcleritis) and 3 central nervous system-related abnormalities. 4 patients presented single findings such as paralytic strabismus (1), pseudopapilloedema (1) and refractive errors (2). Other extracutaneous manifestations were detected in a significantly higher number of patients with ocular involvement and were mostly neurological.

CONCLUSION

Ocular abnormalities are not unusual in patients with JLS, especially in the ECDS subtype. They are frequently associated with other internal organ involvement, particularly the central nervous system (CNS). Careful ophthalmic monitoring is recommended for every patient with JLS, but is mandatory in those with skin lesions on the face and/or concomitant CNS involvement.

摘要

背景

文献中关于局限性硬皮病(LS)眼部受累的现有资料大多是成年患者的单病例描述。本文报告了一大群青少年局限性硬皮病(JLS)患儿眼部受累的频率和具体特征。

方法

来自一项针对LS患儿的大型、多中心、跨国研究的数据用于收集和分析眼部受累的具体信息。

结果

750例患者中有24例(3.2%)出现明显的眼部受累。其中女性16例,男性8例。16例患者(66.7%)面部有“剑伤样”硬皮病(ECDS),5例(20.8%)为线状亚型,2例(8.3%)为泛发性硬斑病(GM),1例(4.2%)为斑块状硬斑病(PM)。在24例眼部受累患者中,10例(41.7%)报告有附件(眼睑和睫毛)异常,7例(29.2%)有前段炎症(5例前葡萄膜炎,2例表层巩膜炎),3例有中枢神经系统相关异常。4例患者有单一表现,如麻痹性斜视(1例)、假性视乳头水肿(1例)和屈光不正(2例)。在眼部受累患者中,检测到的其他皮肤外表现明显更多,且大多为神经系统表现。

结论

眼部异常在JLS患者中并不罕见,尤其是在ECDS亚型中。它们常与其他内脏器官受累相关,尤其是中枢神经系统(CNS)。建议对每例JLS患者进行仔细的眼科监测,但对于面部有皮肤病变和/或伴有CNS受累的患者则是必需的。

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