1 Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
2 Health Administration Center, Niigata University, Niigata, Japan.
Lupus. 2018 Mar;27(3):417-427. doi: 10.1177/0961203317725589. Epub 2017 Aug 18.
Purpose TAFRO syndrome is a novel disorder manifesting as fever, anasarca, thrombocytopenia, renal insufficiency and organomegaly, and its etiology has not been clarified. The aim of this study was to elucidate similarities and differences between systemic lupus erythematosus (SLE) and TAFRO syndrome. Methods We examined 46 consecutive patients diagnosed with SLE and determined whether they meet the proposed diagnostic criteria for TAFRO syndrome (2015 version). Results Of the 46 patients with SLE, four (8.7%) also met the TAFRO syndrome criteria (TAFRO-like group). All patients in the TAFRO-like group were males, and their mean age was significantly higher than that of the non-TAFRO group (67.5 ± 8.7 vs. 39.3 ± 18.1 years, p = 0.004). C-reactive protein and γ-glutamyl transpeptidase levels were significantly higher, and frequencies of anti-dsDNA and anti-Sm antibodies were significantly lower in the TAFRO-like than non-TAFRO group. Elder cases (onset age ≥ 50 years) met significantly more categories of the diagnostic criteria for TAFRO syndrome than did those with younger cases. Conclusions Several patients with SLE, especially elder cases, showed features similar to those of TAFRO syndrome. Although exclusion of SLE is needed in the diagnostic criteria for TAFRO syndrome, TAFRO syndrome-like SLE should be considered.
目的 TAFRO 综合征是一种新的疾病,表现为发热、浮肿、血小板减少、肾功能不全和器官肿大,其病因尚未阐明。本研究旨在阐明系统性红斑狼疮(SLE)和 TAFRO 综合征之间的相似和不同之处。
方法 我们检查了 46 例连续诊断为 SLE 的患者,并确定他们是否符合 TAFRO 综合征(2015 年版)的拟议诊断标准。
结果 在 46 例 SLE 患者中,有 4 例(8.7%)也符合 TAFRO 综合征标准(TAFRO 样组)。TAFRO 样组的所有患者均为男性,其平均年龄明显高于非 TAFRO 组(67.5±8.7 岁比 39.3±18.1 岁,p=0.004)。TAFRO 样组的 C 反应蛋白和γ-谷氨酰转肽酶水平明显升高,抗 dsDNA 和抗 Sm 抗体的频率明显低于非 TAFRO 组。老年病例(发病年龄≥50 岁)符合 TAFRO 综合征诊断标准的类别明显多于年轻病例。
结论 一些 SLE 患者,尤其是老年病例,表现出类似于 TAFRO 综合征的特征。虽然 TAFRO 综合征的诊断标准中需要排除 SLE,但应考虑 TAFRO 综合征样 SLE。