André M, Aumaître O
Service de médecine interne, CHU Gabriel-Montpied, Clermont-Ferrand cedex, France.
Rev Med Interne. 2011 Nov;32(11):678-88. doi: 10.1016/j.revmed.2011.02.001. Epub 2011 Mar 5.
Aseptic abscesses syndrome is a systemic disorder of unknown etiology involving polymorphonuclear neutrophil. Typical presentation of aseptic abscesses syndrome includes fever, abdominal pain and leukocytosis, and is characterized by the presence of intra-abdominal aseptic lesions consisting of neutrophils. The diagnosis relies on a combination of a typical clinical and radiological presentation, the pathological findings, and the exclusion of alternative diagnosis, especially infectious diseases. Antibiotics fail to achieve cure but there is a marked improvement with corticosteroids. Aseptic abscesses syndrome is either associated with another disease such as Crohn's disease or relapsing polychondritis, or is idiopathic. It is often a relapsing condition and the PET may be an interesting diagnostic tool in the setting of recurrent and febrile abdominal pain. An immunosuppressive agent is required in almost half of the patients and anti-TNFα drugs may be used. Aseptic abscesses syndrome shares some features with other disorders such as inflammatory bowel diseases or neutrophilic dermatoses which suggests a genetic susceptibility and a relationship with auto-inflammatory disorders. Further studies on the pathways involved in aseptic abscesses will help to improve diagnosis and treatment.
无菌性脓肿综合征是一种病因不明的涉及多形核中性粒细胞的全身性疾病。无菌性脓肿综合征的典型表现包括发热、腹痛和白细胞增多，其特征是存在由中性粒细胞组成的腹腔内无菌性病变。诊断依赖于典型的临床和影像学表现、病理结果以及排除其他诊断，尤其是传染病。抗生素无法治愈，但使用皮质类固醇有显著改善。无菌性脓肿综合征要么与另一种疾病如克罗恩病或复发性多软骨炎相关，要么是特发性的。它通常是一种复发性疾病，在复发性发热性腹痛的情况下，正电子发射断层扫描（PET）可能是一种有趣的诊断工具。几乎一半的患者需要使用免疫抑制剂，可能会使用抗TNFα药物。无菌性脓肿综合征与其他疾病如炎症性肠病或嗜中性皮病有一些共同特征，这表明存在遗传易感性以及与自身炎症性疾病的关系。对无菌性脓肿相关途径的进一步研究将有助于改善诊断和治疗。
