类风湿性血管炎：消失的威胁还是新疗法的靶点？
Rheumatoid vasculitis: vanishing menace or target for new treatments?
机构信息
University of Wisconsin-Madison School of Medicine and Public Health, William S. Middleton Memorial Veterans Hospital-Madison, 2500 Overlook Terrace, Madison, WI 53705, USA.
出版信息
Curr Rheumatol Rep. 2010 Dec;12(6):414-9. doi: 10.1007/s11926-010-0130-1.
Abstract
Rheumatoid vasculitis is a rare but serious complication of rheumatoid arthritis. Herein we examine the pathophysiology, epidemiology, clinical diagnosis, and treatment of rheumatoid vasculitis. Seropositivity, specific HLA variations, and tobacco use are among the genetic and environmental predictors of rheumatoid vasculitis. Fortunately, recent reports have noted declines in the prevalence of rheumatoid vasculitis. Nevertheless, proper recognition of systemic manifestations may assist in pathologically confirming the diagnosis, determining the extent of disease, and guiding treatment. Contemporary treatment reports are discussed in the context of the ongoing debate regarding whether new agents may trigger, treat, or even prevent rheumatoid vasculitis. Evolving genetic, histopathologic, and immunologic studies partnered with ongoing clinical experience with biologics offer promise to inform future prevention and treatment of rheumatoid vasculitis.
摘要
类风湿性血管炎是类风湿关节炎的一种罕见但严重的并发症。本文探讨了类风湿性血管炎的病理生理学、流行病学、临床诊断和治疗。血清阳性、特定 HLA 变异和吸烟是类风湿性血管炎的遗传和环境预测因素之一。幸运的是，最近的报告指出类风湿性血管炎的患病率有所下降。然而，对全身表现的正确认识可能有助于在病理上确认诊断、确定疾病的程度，并指导治疗。在讨论新的治疗方法是否可能引发、治疗甚至预防类风湿性血管炎的同时，还讨论了当代治疗报告。正在进行的关于遗传、组织病理学和免疫学的研究以及对生物制剂的临床经验为未来预防和治疗类风湿性血管炎提供了希望。
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