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[白癜风患者自身免疫性内分泌疾病的患病率]

[The prevalence of autoimmune endocrine diseases in vitiligo patients].

作者信息

Troshina E A, Volnukhin V A, Petrov V A, Nuralieva N F, Yukina M Y, Orlova E M, Frigo N V

机构信息

Endocrinology Research Centre.

Moscow Research and Practical Center for Dermatovenereology and Cosmetology.

出版信息

Ter Arkh. 2020 Nov 24;92(10):88-96. doi: 10.26442/00403660.2020.10.000736.

Abstract

Vitiligo is a common polygenic autoimmune disease in which the foci of depigmentation are formed on the skin and/or mucous membranes as a result of the death of melanocytes. There are several hypotheses for the pathogenesis of the disease, the leading role among them is played the autoimmune hypothesis. This review summarizes the available literature data on the prevalence and structure of comorbid endocrine autoimmune pathology in vitiligo patients. In most studies conducted in Europe, America and Asia the prevalence of autoimmune thyroid diseases (including autoimmune thyroiditis and Graves disease), diabetes mellitus and autoimmune adrenal insufficiency was higher in vitiligo patients than in the general population. The results of some studies indicate a frequent association of vitiligo with autoimmune polyglandular syndromes. In the structure of comorbid pathology the highest prevalence was in autoimmune thyroid diseases. A number of studies have established a higher prevalence of autoimmune endocrine diseases in women, as well as in nonsegmental vitiligo patients and in cases of family history of vitiligo and/or other autoimmune diseases. In addition, it was shown that the prevalence of endocrine diseases increases with increasing area of depigmentation. The data obtained justify the advisability of conducting a timely examination of vitiligo patients with the aim of early detection of comorbid diseases and the appointment of appropriate treatment. Further studies are needed to investigate the effect of the identified associations on the course of vitiligo and comorbid endocrinopathies, as well as the effectiveness of therapy and the quality of life of patients.

摘要

白癜风是一种常见的多基因自身免疫性疾病,由于黑素细胞死亡,在皮肤和/或黏膜上形成色素脱失斑。关于该疾病的发病机制有多种假说,其中自身免疫假说起主要作用。本综述总结了白癜风患者合并内分泌自身免疫性病理的患病率和结构的现有文献数据。在欧洲、美洲和亚洲进行的大多数研究中,白癜风患者中自身免疫性甲状腺疾病(包括自身免疫性甲状腺炎和格雷夫斯病)、糖尿病和自身免疫性肾上腺功能不全的患病率高于一般人群。一些研究结果表明白癜风与自身免疫性多腺体综合征经常相关。在合并病理结构中,自身免疫性甲状腺疾病的患病率最高。多项研究证实女性、非节段性白癜风患者以及有白癜风和/或其他自身免疫性疾病家族史的患者中自身免疫性内分泌疾病的患病率较高。此外,研究表明内分泌疾病的患病率随着色素脱失面积的增加而升高。所获得的数据证明了及时对白癜风患者进行检查以早期发现合并疾病并给予适当治疗的合理性。需要进一步研究来调查已确定的关联对白癜风病程和合并内分泌疾病的影响,以及治疗效果和患者的生活质量。

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