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纤维性骨发育不良/McCune-Albright 综合征相关神经病理性疼痛。

Neuropathic-like Pain in Fibrous Dysplasia/McCune-Albright Syndrome.

机构信息

Skeletal Disorders and Mineral Homeostasis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.

Department of Metabolism, Digestion and Reproduction, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK.

出版信息

J Clin Endocrinol Metab. 2022 May 17;107(6):e2258-e2266. doi: 10.1210/clinem/dgac120.

Abstract

CONTEXT

Pain is a major symptom in adults with fibrous dysplasia/McCune-Albright syndrome (FD/MAS) and response to current treatments, including bisphosphonates and standard analgesics (nonsteroidal anti-inflammatory drugs and opiates) is unpredictable. No studies have explored whether the type of pain is variable in this patient group.

OBJECTIVE

To determine the frequency of neuropathic-like pain in patients with FD/MAS.

DESIGN

Retrospective, dual registry study.

SETTING

Community.

PATIENTS

FD/MAS online registries: the US-based Familial Dysautonomia Foundation (FDF) and the UK-based Rare and Undiagnosed Diseases (RUDY) study.

INTERVENTION

Subjects completed questionnaires to evaluate the presence of features of neuropathic-like pain (painDETECT) and the impact on sleep quality (Pittsburgh Sleep Quality Index) and mental health (Hospital Anxiety and Depression Scale). Descriptive statistics were used to characterize the prevalence and associated burden of neuropathic-like pain.

MAIN OUTCOME MEASURES

Incidence of neuropathic, nociceptive, and unclear pain.

RESULTS

Of 249 participants, one third experienced neuropathic-like pain. This group had statistically significantly (P < 0.001) worse mental well-being and sleep in comparison to those with predominately nociceptive pain.

CONCLUSIONS

Neuropathic-like pain is common in patients with FD/MAS and associated with worse quality of life. Evaluation of pain in patients with FD/MAS should include assessment of neuropathic-like pain to guide personalized approaches to treatment and inform future research.

摘要

背景

纤维结构不良/麦卡恩-阿尔布赖特综合征(FD/MAS)患者主要症状为疼痛,目前针对该疾病的治疗方法(如双磷酸盐和标准镇痛药(非甾体抗炎药和阿片类药物))疗效并不稳定,无法预测。目前尚未有研究探索此类患者群体的疼痛类型是否存在差异。

目的

明确 FD/MAS 患者中出现神经病理性疼痛的频率。

设计

回顾性、双登记研究。

地点

社区。

患者

FD/MAS 在线登记处:美国家族性自主神经异常基金会(FDF)和英国罕见和未确诊疾病(RUDY)研究。

干预措施

参与者完成问卷,以评估神经病理性疼痛的特征(疼痛 DETECT)及其对睡眠质量(匹兹堡睡眠质量指数)和心理健康(医院焦虑和抑郁量表)的影响。采用描述性统计方法来描述神经病理性疼痛的流行程度和相关负担。

主要观察指标

神经病理性、伤害感受性和不明原因疼痛的发生率。

结果

在 249 名参与者中,三分之一经历过神经病理性疼痛。与主要表现为伤害感受性疼痛的患者相比,该组患者的心理健康状况和睡眠质量明显更差(P<0.001)。

结论

神经病理性疼痛在 FD/MAS 患者中较为常见,且与生活质量较差相关。评估 FD/MAS 患者的疼痛时,应包括对神经病理性疼痛的评估,以指导个体化的治疗方法,并为未来的研究提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a008/9113795/cab62e25fd45/dgac120_fig1.jpg

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