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银屑病与自身免疫性疾病的关联:一项初步研究的结果。

Association of Psoriasis with Autoimmune Disorders: Results of a Pilot Study.

作者信息

Vashist Sanket, Mahajan Vikram K, Mehta Karaninder S, Chauhan Pushpinder S, Yadav Rajinder S, Sharma Satya Bhushan, Sharma Vikas, Sharma Anuj, Chowdhary Bhumika, Kumar Prabal

机构信息

Department of Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India.

Department of Biochemistry, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India.

出版信息

Indian Dermatol Online J. 2020 Sep 19;11(5):753-759. doi: 10.4103/idoj.IDOJ_648_19. eCollection 2020 Sep-Oct.

Abstract

BACKGROUND

Association of psoriasis with other autoimmune diseases remains an ongoing research subject.

OBJECTIVES

To investigate the association of psoriasis with other autoimmune disorders.

MATERIALS AND METHODS

We studied 80 (M: F 57:23) psoriasis patients aged 13-75 years for concurrent autoimmune disorders. After clinical examination, hemogram, fasting blood sugar, HbA1c, thyroid function tests, anti-TPO antibody, rheumatoid factor, anti-tTG antibody, anti-CCP antibody, ANA, anti-dsDNA antibody, anti-Ro antibody, and fecal calprotectin were estimated.

RESULTS

Mild-to-moderate and severe psoriasis was present in 86.3% and 13.8% patients, respectively. Psoriatic arthritis was present in 3.8% patients, all of whom also had severe psoriasis. Only 37 (46.3%) patients had clinical and/or sero-abnormality suggestive of autoimmune disorders; vitiligo in 3.8%, type-1 diabetes mellitus (DM) in 1.3%, and type-2 DM in 6.3% patients. Sero-positivity reflecting subclinical autoimmunity was noted for anti-CCP antibodies (in 2.5%), rheumatoid factor (in 2.5%), hypo- or hyper-thyroidism (in 8.8%), anti-TPO antibodies (in 5.0%), anti-tTG antibody (in 1.3%), ANA (in 5.0%), anti-dsDNA antibody (in 2.5%), and anti-Ro antibody in 11.3% patients. Elevated fecal calprotectin levels suggestive of inflammatory bowel disease (IBD) occurred in 11.2% of 27 patients. Multiple abnormalities happened in 2.5% patients.

CONCLUSION

Apparently psoriasis patients seem to have a predilection for other autoimmune disorders particularly for vitiligo, diabetes mellitus, autoimmune thyroiditis, rheumatoid arthritis, and IBD. However, association between psoriasis and other autoimmune disorders at best remains tenuous for want of strong evidence. Nevertheless, screening for them will improve overall management of these patients. Cross-sectional study design and small number of study subjects remain important limitations.

摘要

背景

银屑病与其他自身免疫性疾病的关联仍是一个正在进行研究的课题。

目的

研究银屑病与其他自身免疫性疾病的关联。

材料与方法

我们研究了80名年龄在13至75岁之间的银屑病患者(男:女为57:23),以确定是否存在并发的自身免疫性疾病。经过临床检查后,对血常规、空腹血糖、糖化血红蛋白、甲状腺功能测试、抗甲状腺过氧化物酶抗体、类风湿因子、抗组织转谷氨酰胺酶抗体、抗环瓜氨酸肽抗体、抗核抗体、抗双链DNA抗体、抗Ro抗体以及粪便钙卫蛋白进行了检测。

结果

轻度至中度和重度银屑病患者分别占86.3%和13.8%。银屑病关节炎患者占3.8%,所有这些患者也患有重度银屑病。只有37名(46.3%)患者有提示自身免疫性疾病的临床和/或血清学异常;白癜风患者占3.8%,1型糖尿病患者占1.3%,2型糖尿病患者占6.3%。抗环瓜氨酸肽抗体(2.5%)、类风湿因子(2.5%)、甲状腺功能减退或亢进(8.8%)、抗甲状腺过氧化物酶抗体(5.0%)、抗组织转谷氨酰胺酶抗体(1.3%)、抗核抗体(5.0%)、抗双链DNA抗体(2.5%)以及抗Ro抗体(11.3%)的血清阳性反映了亚临床自身免疫。27名患者中有11.2%的粪便钙卫蛋白水平升高提示炎症性肠病(IBD)。2.5%的患者出现多种异常。

结论

显然,银屑病患者似乎易患其他自身免疫性疾病,尤其是白癜风、糖尿病、自身免疫性甲状腺炎、类风湿关节炎和炎症性肠病。然而,由于缺乏有力证据,银屑病与其他自身免疫性疾病之间的关联充其量仍然很微弱。尽管如此,对这些疾病进行筛查将改善这些患者的整体管理。横断面研究设计以及研究对象数量较少仍然是重要的局限性。

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