Trefond Ludovic, Frances Camille, Costedoat-Chalumeau Nathalie, Piette Jean-Charles, Haroche Julien, Sailler Laurent, Assaad Souad, Viallard Jean-François, Jego Patrick, Hot Arnaud, Connault Jerome, Galempoix Jean-Marc, Aslangul Elisabeth, Limal Nicolas, Bonnet Fabrice, Faguer Stanislas, Chosidow Olivier, Deligny Christophe, Lifermann François, Maria Alexandre Thibault Jacques, Pereira Bruno, Aumaitre Olivier, André Marc
Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France.
M2iSH, UMR 1071 Inserm, INRA USC 2018, University of Clermont Auvergne, 63000 Clermont-Ferrand, France.
J Clin Med. 2022 Jun 25;11(13):3669. doi: 10.3390/jcm11133669.
Aseptic abscess (AA) syndrome is a rare type of inflammatory disorder involving polymorphonuclear neutrophils (PMNs), often associated with inflammatory bowel disease (IBD). This study sought to describe the clinical characteristics and evolution of this syndrome in a large cohort. We included all patients included in the French AA syndrome register from 1999 to 2020. All patients fulfilled the criteria outlined by André et al. in 2007. Seventy-one patients were included, 37 of which were men (52.1%), of a mean age of 34.5 ± 17 years. The abscesses were located in the spleen (71.8%), lymph nodes (50.7%), skin (29.5%), liver (28.1%), lung (22.5), and rarer locations (brain, genitals, kidneys, ENT, muscles, or breasts). Of all the patients, 59% presented with an associated disease, primarily IBD (42%). They were treated with colchicine (28.1%), corticosteroids (85.9%), immunosuppressants (61.9%), and biologics (32.3%). A relapse was observed in 62% of cases, mostly in the same organ. Upon multivariate analysis, factors associated with the risk of relapse were: prescription of colchicine (HR 0.52; 95% CI [0.28-0.97]; = 0.042), associated IBD (HR 0.57; 95% CI [0.32-0.99]; = 0.047), and hepatic or skin abscesses at diagnosis (HR 2.14; 95% CI [1.35-3.40]; = 0.001 and HR 1.78; 95% CI [1.07-2.93]; = 0.024, respectively). No deaths occurred related to this disease. This large retrospective cohort study with long follow up showed that AA syndrome is a relapsing systemic disease that can evolve on its own or be the precursor of an underlying disease, such as IBD. Of all the available treatments, colchicine appeared to be protective against relapse.
无菌性脓肿（AA）综合征是一种罕见的炎症性疾病，涉及多形核中性粒细胞（PMN），常与炎症性肠病（IBD）相关。本研究旨在描述该综合征在一个大型队列中的临床特征和演变情况。我们纳入了1999年至2020年法国AA综合征登记册中的所有患者。所有患者均符合André等人在2007年概述的标准。共纳入71例患者，其中37例为男性（52.1%），平均年龄为34.5±17岁。脓肿位于脾脏（71.8%）、淋巴结（50.7%）、皮肤（29.5%）、肝脏（28.1%）、肺部（22.5%）以及较罕见的部位（脑、生殖器、肾脏、耳鼻喉、肌肉或乳房）。所有患者中，59%患有相关疾病，主要是IBD（42%）。他们接受了秋水仙碱（28.1%）、皮质类固醇（85.9%）、免疫抑制剂（61.9%）和生物制剂（32.3%）的治疗。62%的病例出现复发，大多发生在同一器官。多因素分析显示，与复发风险相关 的因素有：秋水仙碱的使用（HR 0.52；95%CI[0.28 - 0.97]；P = 0.042）、合并IBD（HR 0.57；95%CI[0.32 - 0.99]；P = 0.047）以及诊断时存在肝脓肿或皮肤脓肿（HR 2.14；95%CI[1.35 - 3.40]；P = 0.001和HR 1.78；95%CI[1.07 - 2.93]；P = 0.024）。未发生与该疾病相关的死亡病例。这项长期随访的大型回顾性队列研究表明，AA综合征是一种复发性全身性疾病，可自行发展或成为潜在疾病（如IBD）的先兆。在所有可用治疗方法中，秋水仙碱似乎对预防复发有保护作用。
