Andersen Christen Lykkegaard, Kristensen Thomas Kielsgaard, Severinsen Marianne Tang, Møller Michael Boe, Vestergaard Hanne, Bergmann Olav J, Hasselbalch Hans Carl, Bjerrum Ole Weis
Department of Haematology, Roskilde Hospital, Denmark.
Dan Med J. 2012 Mar;59(3):A4397.
The mast cell lives a hidden life, but it is implicated in several physiological reactions. Its ability to react to different stimuli impacts a variety of conditions such as asthma, atopic dermatitis, urticaria and anaphylaxis. It is not until recent decades that the evolution of the cell has been described and its fascinating biology has only recently been depicted. We here give a review of systemic mastocytosis in regards to cell biology, diagnostic approaches and clinical practice.
A search was made in PubMed in August 2011 entering the keywords: mastocytosis, (systemic, cutaneous, aggressive), mast cell leukaemia, mast cell sarcoma, chromosome, mutation, haematology and treatment.
Mastocytosis is characterized by an abnormal proliferation of mast cells, which accumulate in one or several organ systems, primarily the skin and bone marrow. The disease is clinically heterogeneous and varies from a relatively benign condition with isolated cutaneous lesions to a very aggressive systemic condition with a grave prognosis. The condition affects men and women equally. Children are especially affected by the cutaneous form. In most children, the condition will improve or remit spontaneously before adulthood. Mastocytosis in adults, however, is more often systemic and tends to persist.
Patients with mastocytosis represent a heterogeneous group in terms of clinical presentation, management and prognosis. Furthermore, a range of medical specialties serve as the primary entrance to health services, which can be a challenge in respect of achieving uniform management. In order to improve diagnostics and management of systemic mastocytosis, the European Competence Network on Mastocytosis has been established. Patients under suspicion of systemic mastocytosis should be conferred with or referred to a haematological and a dermatological/allergological department.
肥大细胞的存在较为隐匿,但它参与了多种生理反应。其对不同刺激作出反应的能力会影响多种病症,如哮喘、特应性皮炎、荨麻疹和过敏反应。直到最近几十年,才对该细胞的进化进行了描述,其迷人的生物学特性也只是在近期才得以描绘。我们在此就细胞生物学、诊断方法及临床实践方面对系统性肥大细胞增多症进行综述。
2011年8月在PubMed中进行检索,输入关键词:肥大细胞增多症、(系统性、皮肤性、侵袭性)、肥大细胞白血病、肥大细胞肉瘤、染色体、突变、血液学及治疗。
肥大细胞增多症的特征是肥大细胞异常增殖,这些细胞在一个或多个器官系统中积聚,主要是皮肤和骨髓。该疾病在临床上具有异质性,从仅有孤立皮肤病变的相对良性病症到预后严重的极具侵袭性的系统性病症不等。该病症对男性和女性的影响相同。儿童尤其易患皮肤型肥大细胞增多症。在大多数儿童中,该病在成年前会自行改善或缓解。然而,成人的肥大细胞增多症更常为系统性,且往往持续存在。
肥大细胞增多症患者在临床表现、管理及预后方面均为异质性群体。此外,一系列医学专科是患者获得医疗服务的主要途径,这在实现统一管理方面可能是一项挑战。为了改善系统性肥大细胞增多症的诊断和管理,已建立了欧洲肥大细胞增多症专家网络。疑似系统性肥大细胞增多症的患者应咨询血液科及皮肤科/过敏科或转诊至这些科室。