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小儿白塞病:一家三级医疗中心的经验

Pediatric Behçet's disease: Experience of a single tertiary center.

作者信息

Açarı Ceyhun, İşgüder Rana, Torun Rüya, Makay Balahan, Ünsal Şevket Erbil

机构信息

Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, Izmir, Türkiye.

出版信息

Arch Rheumatol. 2022 Oct 21;38(2):282-290. doi: 10.46497/ArchRheumatol.2023.9651. eCollection 2023 Jun.

Abstract

OBJECTIVES

The aim of this study was to examine the clinical and phenotypic features of pediatric Behçet's disease (PEDBD) in our clinic and present the rates of fulfilling the diagnostic criteria.

PATIENTS AND METHODS

Thirty-four patients (20 males, 14 females; mean age: 16.0±2.1 years; range, 10 to 18 years) diagnosed with PEDBD between January 2010 and December 2019 were retrospectively evaluated. Patients were reclassified according to 1990 International Study Group (ISG) criteria, 2014 International Criteria for Behçet's Disease (ICBD), and PEDBD criteria.

RESULTS

The mean age at diagnosis was 12.6±3.1 years, the median diagnosis delay time was 12.0 (range, 4.5 to 27.0) months, and the mean age at symptom onset was 10.8±2.9 years. The mean follow-up period was 31.9±20.9 months. Oral aphthous ulcer was observed in 33 (97.1%), genital ulcer in 16 (47.0%), ocular involvement in 15 (44.1%), skin lesion in 11 (32.3%), joint involvement in nine (26.4%), both vascular and neurological involvement in six (17.6%) patients. The pathergy test was positive in 11 (37.8%) patients, and human leukocyte antigen (HLA)-B51 was positive in 11 (78.5%) of 14 patients. The rates of patients meeting the criteria for ISG, ICBD, and PEDBD were 52.9%, 82.4%, and 50.0%, respectively.

CONCLUSION

Pathergy and HLA-B51 can be used as supportive findings in patients who do not meet the diagnostic criteria. However, expert opinion is still the gold standard in diagnosis.

摘要

目的

本研究旨在探讨我院儿科白塞病(PEDBD)的临床和表型特征,并呈现符合诊断标准的比例。

患者与方法

回顾性评估2010年1月至2019年12月期间诊断为PEDBD的34例患者(20例男性,14例女性;平均年龄:16.0±2.1岁;范围10至18岁)。根据1990年国际研究组(ISG)标准、2014年白塞病国际标准(ICBD)和PEDBD标准对患者进行重新分类。

结果

诊断时的平均年龄为12.6±3.1岁,中位诊断延迟时间为12.0(范围4.5至27.0)个月,症状出现时的平均年龄为10.8±2.9岁。平均随访期为31.9±20.9个月。33例(97.1%)出现口腔阿弗他溃疡,16例(47.0%)出现生殖器溃疡,15例(44.1%)出现眼部受累,11例(32.3%)出现皮肤病变,9例(26.4%)出现关节受累,6例(17.6%)患者同时出现血管和神经受累。11例(37.8%)患者的针刺试验呈阳性,14例患者中有11例(78.5%)人类白细胞抗原(HLA)-B51呈阳性。符合ISG、ICBD和PEDBD标准的患者比例分别为52.9%、82.4%和50.0%。

结论

针刺试验和HLA-B51可作为不符合诊断标准患者的支持性检查结果。然而,专家意见仍是诊断的金标准。

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