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春季角结膜炎:过敏和自身免疫。

Vernal keratoconjunctivitis: atopy and autoimmunity.

机构信息

Department of Pediatrics, Sapienza University of Rome, Rome, Italy.

出版信息

Eur Rev Med Pharmacol Sci. 2013 May;17(10):1419-23.

Abstract

BACKGROUND

Vernal Keratoconjunctivitis (VKC) is a rare chronic ocular inflammatory disease and it mainly affects boys in the first decade of life. Although it is a self-limiting disease, patients may present many phases characterized by an exacerbation of inflammatory symptoms with a consequent decline of the quality of life.

PURPOSE

define the clinical and immunological profile of patients affected by VKC and investigate their familiar history of autoimmune disorders and their autoimmunity pattern.

PATIENTS AND METHODS

28 children were enrolled (20 males, 71%) aged between 4 and 14 years of life affected by VKC. Family history of allergic and immunological diseases was collected for each patient. In particular, it was asked whether some components of their families were affected by Hashimoto's thyroiditis, type I diabetes, psoriasis or rheumatoid arthritis and Systemic Lupus Erythematosus (SLE). All VKC children underwent a serological evaluation of anti-nuclear antibodies (ANA).

RESULTS

A family history of immunological disorders was found in 46% of patients, 28% of Hashimoto's thyroiditis, 14% of type I diabetes, 14% of psoriasis, and 1 of Systemic Lupus Erythematosus. Furthermore, 35% of patients was ANA positive and they corresponded to patients with a higher ocular score and with the most important clinical symptoms.

CONCLUSIONS

the detection of ANA positivity and of a familiar history of autoimmune disorders in a high percentage of children with VKC may help us to better understand the association of this ocular inflammatory disease with systemic autoimmune disorders and atopic condition.

摘要

背景

春季角结膜炎(VKC)是一种罕见的慢性眼部炎症性疾病,主要影响生命的第一个十年中的男孩。尽管它是一种自限性疾病,但患者可能会出现许多阶段,其特征是炎症症状加重,导致生活质量下降。

目的

定义受 VKC 影响的患者的临床和免疫学特征,并研究他们自身免疫性疾病的家族史及其自身免疫模式。

患者和方法

共纳入 28 名(20 名男性,71%)4 至 14 岁患有 VKC 的儿童。为每位患者收集了过敏和免疫病史家族史。特别是,询问他们的家庭成员是否有桥本甲状腺炎、1 型糖尿病、银屑病或类风湿关节炎和系统性红斑狼疮(SLE)的一些成分。所有 VKC 儿童均接受抗核抗体(ANA)的血清学评估。

结果

46%的患者有免疫性疾病家族史,28%的患者有桥本甲状腺炎,14%的患者有 1 型糖尿病,14%的患者有银屑病,1 例系统性红斑狼疮。此外,35%的患者 ANA 阳性,他们对应于眼部评分较高和具有最重要临床症状的患者。

结论

在患有 VKC 的儿童中,ANA 阳性和自身免疫性疾病家族史的检出率较高,这可能有助于我们更好地理解这种眼部炎症性疾病与全身性自身免疫性疾病和特应性条件的关联。

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