Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115, USA.
Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA, USA.
Pediatr Rheumatol Online J. 2023 Sep 12;21(1):101. doi: 10.1186/s12969-023-00887-8.
Sweet syndrome (SS), also known as acute febrile neutrophilic dermatosis, is an immunologic syndrome characterized by widespread neutrophilic infiltration. Histiocytoid Sweet syndrome (H-SS) is a histopathologic variant of SS. While SS most commonly occurs in adults, this case report discusses an infant patient who presented with H-SS.
Through a multidisciplinary approach, this patient was also found to have very early onset inflammatory bowel disease (VEO-IBD) and Mevalonate kinase-associated disease (MKAD). While prior case studies have characterized an association between VEO-IBD and MKAD, there is no literature describing the association of all three diagnoses this case: H-SS, VEO-IBD and MKAD. Initiation of canakinumab in this patient resulted in successful control of the disease.
This case highlights the importance of a multidisciplinary approach to rare diagnoses, and collaboration during cases with significant diagnostic uncertainty.
Sweet 综合征(SS),又称急性发热性嗜中性皮病,是一种以广泛中性粒细胞浸润为特征的免疫综合征。组织细胞样 Sweet 综合征(H-SS)是 SS 的一种组织病理学变异。SS 最常发生在成人中,但本病例报告讨论了一名患有 H-SS 的婴儿患者。
通过多学科方法,该患者还被发现患有非常早发性炎症性肠病(VEO-IBD)和甲羟戊酸激酶相关疾病(MKAD)。虽然之前的病例研究已经描述了 VEO-IBD 和 MKAD 之间的关联,但没有文献描述本病例中所有三种诊断的关联:H-SS、VEO-IBD 和 MKAD。在该患者中使用卡那单抗治疗取得了疾病的成功控制。
本病例强调了对罕见诊断采用多学科方法的重要性,以及在具有重大诊断不确定性的病例中进行合作的重要性。