Norwich Medical School, University of East Anglia, Norwich, UK.
Department of Internal Medicine, Division of Rheumatology and Behçet's Disease Research Centre, Istanbul University-Cerrahpaşa, Istanbul, Turkey.
Nat Rev Rheumatol. 2022 Jan;18(1):22-34. doi: 10.1038/s41584-021-00718-8. Epub 2021 Dec 1.
The many forms of vasculitis are characterized by inflammation of blood vessels, leading to potentially long-term sequelae including vision loss, aneurysm formation and kidney failure. Accurate estimation of the incidence and prevalence has been hampered by the absence of reliable diagnostic criteria and the rarity of these conditions; however, much progress has been made over the past two decades, although data are still lacking from many parts of the world including the Indian subcontinent, China, Africa and South America. Giant cell arteritis occurs in those aged 50 years and over and seems to mainly affect persons of northern European ancestry, whereas Takayasu arteritis occurs mainly in those aged under 40 years. By contrast, Kawasaki disease mainly occurs in children aged under 5 years and is most common in children of Asian ancestry, and IgA vasculitis occurs in children and adolescents. Although much less common than giant cell arteritis, the different forms of antineutrophil cytoplasmic antibody-associated vasculitis are being increasingly recognized in most populations and occur more frequently with increasing age. Behçet syndrome occurs most commonly along the ancient silk road between Europe and China. Much work needs to be done to better understand the influence of ethnicity, geographical location, environment and social factors on the development of vasculitis.
多种血管炎的特征是血管炎症,可导致潜在的长期后果,包括视力丧失、动脉瘤形成和肾衰竭。由于缺乏可靠的诊断标准和这些疾病的罕见性,准确估计发病率和患病率一直受到阻碍;然而,在过去的二十年中已经取得了很大的进展,尽管包括印度次大陆、中国、非洲和南美洲在内的许多地区仍然缺乏数据。巨细胞动脉炎发生在 50 岁及以上的人群中,似乎主要影响北欧血统的人,而 Takayasu 动脉炎主要发生在 40 岁以下的人群中。相比之下,川崎病主要发生在 5 岁以下的儿童中,在亚洲血统的儿童中最为常见,IgA 血管炎发生在儿童和青少年中。尽管比巨细胞动脉炎少见得多,但在大多数人群中,抗中性粒细胞胞质抗体相关性血管炎的不同形式越来越被认识到,并且随着年龄的增长发病率更高。贝切特综合征最常见于欧洲和中国之间的古代丝绸之路上。需要做更多的工作来更好地了解种族、地理位置、环境和社会因素对血管炎发展的影响。
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