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日本早期可能患有白塞病且主要器官受累为变异型患者的临床特征

Clinical features of early-stage possible Behçet's disease patients with a variant-type major organ involvement in Japan.

作者信息

Suzuki Takeharu, Horita Nobuyuki, Takeuchi Masaki, Ishido Takehito, Mizuki Yuki, Mizuki Ryuta, Kawagoe Tatsukata, Shibuya Etsuko, Yuta Kentaro, Yamane Takahiro, Hayashi Takahiko, Meguro Akira, Ishido Mizuho, Minegishi Kaoru, Yoshimi Ryusuke, Kirino Yohei, Kato Shingo, Arimoto Jun, Fukumoto Takeshi, Ishigatsubo Yoshiaki, Kurosawa Michiko, Takeno Mitsuhiro, Kaneko Takeshi, Mizuki Nobuhisa

机构信息

a Department of Ophthalmology and Visual Science , Yokohama City University Graduate School of Medicine , Yokohama , Japan.

b Department of Pulmonology , Yokohama City University Graduate School of Medicine , Yokohama , Japan.

出版信息

Mod Rheumatol. 2019 Jul;29(4):640-646. doi: 10.1080/14397595.2018.1494501. Epub 2018 Nov 28.

Abstract

Clinical data of patients with entro-, vasculo-, and neuro-variant possible Behçet's disease (BD) based on Japanese criteria has not yet comprehensively reported. This ongoing nation-wide registration has been carried out by the Japanese Ministry of Health, Labour and Welfare. The Ministry asked physicians who diagnosed a patient with confirmed or possible BD to register the patient data by filling out a registration form. The Ministry provided us with the dataset after unlinkable anonymization. We analyzed 2003-2014 database generated from the early stage new cases. Among the 7950 analyzable cases, 694 (8.7%) had variant-type possible BD without satisfying complete/incomplete criteria. Of the 694 patients, 479, 46, and 169 had entero-, vasculo-, and neuro-variant possible BD, respectively. Out of these 694 patients, 35 (5.0%) and 154 (22.2%) satisfied the International Study Group criteria and the International Criteria of BD, respectively. Entero-variant possible patients rarely (1.8%) had ocular lesions. Patients with vasculo-variant possible BD were featured by low genital ulceration risk (6.8%) and frequent positive HLA-B51 (60.0%). Neuro-variant possible BD was featured by high median age at registration (48 year). Vasculo- (69.6%) and neuro-variant (68.6%) BD patients showed clear male dominance. Epididymitis was very rare among variant-type possible BD men. We analyzed 694 early-stage variant-type possible BD cases. We believe the data from our study will contribute to further international discussion regarding BD diagnostic criteria and clarification of the clinical presentations of the Japanese variant-type possible BD patients.

摘要

基于日本标准的肠型、血管型和神经型疑似白塞病(BD)患者的临床数据尚未得到全面报道。这项正在进行的全国性登记工作由日本厚生劳动省开展。该部门要求诊断为确诊或疑似BD的医生通过填写登记表来登记患者数据。在进行不可链接的匿名化处理后,该部门为我们提供了数据集。我们分析了2003年至2014年早期新病例产生的数据库。在7950例可分析病例中,694例(8.7%)患有不符合完全/不完全标准的变异型疑似BD。在这694例患者中,分别有479例、46例和169例患有肠型、血管型和神经型疑似BD。在这694例患者中,分别有35例(5.0%)和154例(22.2%)符合国际研究组标准和BD国际标准。肠型疑似患者很少(1.8%)有眼部病变。血管型疑似BD患者的特点是生殖器溃疡风险低(6.8%)且HLA - B51阳性率高(60.0%)。神经型疑似BD的特点是登记时年龄中位数高(48岁)。血管型(69.6%)和神经型(68.6%)BD患者明显以男性为主。在变异型疑似BD男性中附睾炎非常罕见。我们分析了694例早期变异型疑似BD病例。我们相信我们研究的数据将有助于进一步开展关于BD诊断标准的国际讨论,并阐明日本变异型疑似BD患者的临床表现。

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