Internal Medicine Department, University Hospital Angers, 4 rue Larrey, Angers, France.
Arthritis Care Res (Hoboken). 2011 Aug;63(8):1188-94. doi: 10.1002/acr.20504.
The presence of systemic and/or immune manifestations in myelodysplasia has been currently reported. The influence of these manifestations on the natural outcome of myelodysplastic syndrome has to be considered. We present a multicenter retrospective study (2002-2009) of patients with myelodysplastic syndrome disclosing systemic and/or immune manifestations.
Forty-six patients with myelodysplasia presenting with systemic and/or immune manifestations were compared in terms of survival with 189 patients with myelodysplasia lacking these features.
The clinical picture in these cases consisted of fever (13%), arthralgia or arthritis (13%), and cutaneous manifestations (67%). Four cases of systemic vasculitis have been reported in our series, and they have a worse prognosis. Immune anomalies were recorded in 29% of the cases, and the presence of cryoglobulins was also associated with a worse prognosis.
A difference in survival between patients with myelodysplastic syndrome with systemic manifestations and patients lacking these manifestations has been observed in the presence of systemic vasculitis and/or cryoglobulins.
目前已有报道称骨髓增生异常综合征存在全身和/或免疫表现。这些表现对骨髓增生异常综合征自然病程的影响需要加以考虑。我们报告了一项多中心回顾性研究(2002-2009 年),研究对象为出现全身和/或免疫表现的骨髓增生异常综合征患者。
将 46 例出现全身和/或免疫表现的骨髓增生异常综合征患者与 189 例无这些特征的骨髓增生异常综合征患者的生存情况进行比较。
这些病例的临床表现包括发热(13%)、关节痛或关节炎(13%)和皮肤表现(67%)。在我们的研究中报告了 4 例系统性血管炎病例,这些病例的预后较差。29%的病例存在免疫异常,且存在冷球蛋白血症也与较差的预后相关。
在存在系统性血管炎和/或冷球蛋白血症的情况下,骨髓增生异常综合征患者的生存情况与无这些表现的患者存在差异。