Department of Radiology, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan.
Department of Pathology, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan.
Jpn J Radiol. 2023 Jul;41(7):723-732. doi: 10.1007/s11604-023-01394-2. Epub 2023 Feb 2.
The purpose of this study was to investigate the incidence of multiple organ calcification and the correlation between multiple organ calcification and clinical severity in patients with thrombocytopenia, anasarca, fever, reticulin fibrosis, renal dysfunction, and organomegaly (TAFRO) syndrome.
We retrospectively identified 13 patients with TAFRO syndrome who were treated at our hospital between February 2019 and March 2021. Computed tomography (CT) images of TAFRO patients, which were acquired at admission and one month after admission, were evaluated. Additionally, clinical and laboratory data related to organ calcification and severity classification of TAFRO syndrome were investigated. The correlation between the presence of organ calcification on CT and TAFRO syndrome-severity classification was evaluated.
One month after admission, calcification of the myocardium, adrenal glands, gallbladder wall, pancreas, kidney, skeletal muscle, and skin were observed in 38%, 46%, 15%, 15%, 15%, 23%, and 15% of the thirteen patients, respectively. The occurrence rate of calcifications in the myocardium, adrenal glands, and skeletal muscle was significantly higher in patients with a grade 4 or higher clinical severity than in those with a level up to grade 3 (p = 0.001, p = 0.005, and p = 0.035, respectively).
Our results suggest that the higher the clinical severity in patients with TAFRO syndrome, the higher is the frequency of calcification in the myocardium, adrenal glands, and skeletal muscle; therefore, the assessment of these organ calcifications on CT images may be useful in predicting the severity of TAFRO syndrome.
本研究旨在探讨血小板减少症、浮肿、发热、网状纤维变性、肾功能不全和器官肿大（TAFRO）综合征患者发生多器官钙化的情况及其与临床严重程度的相关性。
我们回顾性地确定了 2019 年 2 月至 2021 年 3 月在我院接受治疗的 13 例 TAFRO 综合征患者。对 TAFRO 患者入院时和入院后一个月的计算机断层扫描（CT）图像进行评估。此外，还研究了与器官钙化和 TAFRO 综合征严重程度分类相关的临床和实验室数据。评估了 CT 上存在器官钙化与 TAFRO 综合征严重程度分类之间的相关性。
在入院后一个月，13 例患者中分别有 38%、46%、15%、15%、15%、23%和 15%的患者出现心肌、肾上腺、胆囊壁、胰腺、肾脏、骨骼肌和皮肤钙化。在临床严重程度为 4 级或更高的患者中，心肌、肾上腺和骨骼肌发生钙化的发生率明显高于临床严重程度为 3 级及以下的患者（p=0.001，p=0.005，p=0.035）。
我们的研究结果表明，TAFRO 综合征患者的临床严重程度越高，心肌、肾上腺和骨骼肌发生钙化的频率越高；因此，CT 图像上这些器官钙化的评估可能有助于预测 TAFRO 综合征的严重程度。
