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德戈斯病——恶性萎缩性丘疹病或皮肤肠道致命综合征:该疾病的罕见性。

Degos disease - malignant atrophic papulosis or cutaneointestinal lethal syndrome: rarity of the disease.

作者信息

Pirolla Eduardo, Fregni Felipe, Miura Irene K, Misiara Antonio Carlos, Almeida Fernando, Zanoni Esdras

机构信息

Spaulding Rehabilitation Network Research Laboratory, Harvard Medical School, Boston, MA, USA.

University of São Paulo, Sirio Libanes Hospital, São Paulo, Brazil.

出版信息

Clin Exp Gastroenterol. 2015 Apr 16;8:141-7. doi: 10.2147/CEG.S59794. eCollection 2015.

Abstract

BACKGROUND

Degos disease is a very rare syndrome with a rare type of multisystem vasculopathy of unknown cause that affects the skin, gastrointestinal tract, and central nervous system. Other organs such as the kidneys, lungs, pleura, liver, heart, and eyes, can also be involved.

OBJECTIVE

To highlight the incidence of Degos disease with regard to age and sex, discuss the necessity of its accurate and early diagnosis, and demonstrate the most current techniques for its diagnosis; to discuss whether early therapeutic intervention can impact patient prognosis; and to present a literature review about this disease.

DESIGN

With a retrospective, observational, nonrandomized trial, we described the evolution of the different forms of Degos disease and referenced the literature.

DATA SOURCES

Research on rare documented cases in the literature, including two cases of potentially lethal form of the disease involving the skin and gastrointestinal system and, possibly, the lungs, kidneys, and central nervous system. A case of the benign form of the disease involving the skin was observed by the authors.

MAIN OUTCOME MEASURES

Differences between outcomes in patients with the cutaneointestinal form and skin-only form of the disease. There was one fatal outcome. We reviewed possible new approaches to diagnosis and treatment.

RESULTS

The study demonstrated the rapid evolution of the aggressive and malignant form of the disease. It also described newly accessible Phase I diagnostic tools being currently researched as well as new therapeutic approaches.

LIMITATION

The rarity of the disease, with only eleven cases throughout the literature.

CONCLUSION

The gastrointestinal form of Degos disease can be lethal. Its vascular etiology has finally been confirmed; however, new and more accurate early diagnostic modalities need to be developed. There are new therapeutic possibilities, but the studies of them are still in the early stages and have not yet shown the full effectiveness of these new therapies.

摘要

背景

迪戈斯病是一种非常罕见的综合征,是一种病因不明的罕见多系统血管病变,可累及皮肤、胃肠道和中枢神经系统。肾脏、肺、胸膜、肝脏、心脏和眼睛等其他器官也可能受累。

目的

强调迪戈斯病在年龄和性别方面的发病率,讨论准确早期诊断该病的必要性,并展示其最新诊断技术;探讨早期治疗干预是否会影响患者预后;并对该疾病进行文献综述。

设计

通过回顾性、观察性、非随机试验,我们描述了迪戈斯病不同形式的演变并参考了文献。

数据来源

对文献中罕见记录病例的研究,包括两例涉及皮肤和胃肠道系统且可能累及肺、肾和中枢神经系统的潜在致死性疾病病例。作者观察到一例涉及皮肤的良性疾病病例。

主要观察指标

皮肤肠道型和仅皮肤型疾病患者结局的差异。有一例致命结局。我们回顾了可能的新诊断和治疗方法。

结果

该研究证明了该疾病侵袭性和恶性形式的快速演变。它还描述了目前正在研究的新的一期诊断工具以及新的治疗方法。

局限性

该疾病罕见,文献中仅有11例病例。

结论

迪戈斯病的胃肠道型可能致命。其血管病因最终已得到证实;然而,需要开发新的、更准确的早期诊断方法。有新的治疗可能性,但对它们的研究仍处于早期阶段,尚未显示出这些新疗法的全部有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab12/4403817/b518de527dba/ceg-8-141Fig1.jpg

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