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抗 TIF1 抗体相关性皮肌炎患者的临床特征:基于病例的综合回顾。

Clinical features of dermatomyositis patients with anti-TIF1 antibodies: A case based comprehensive review.

机构信息

Division of Rheumatology, Department of Internal Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.

Division of Rheumatology, Department of Internal Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.

出版信息

Autoimmun Rev. 2023 Dec;22(12):103464. doi: 10.1016/j.autrev.2023.103464. Epub 2023 Oct 19.

Abstract

BACKGROUND AND OBJECTIVES

Dermatomyositis is chronic autoimmune disease primarily affecting skin and muscles. Antibodies are key players of pathogenesis and are in strong correlation with distinct clinical phenotypes. We present a case and a comprehensive review of the literature on dermatomyositis patients with Anti TIF1 antibodies.

METHODS

PubMed and Web of Science databases were reviewed. 166 articles were identified; 95 of them were evaluated; 79 of them included to the study. 45 of the included articles were case reports 9 were case series and 25 were research articles. In total 1065 patients were identified but number of patients with available information for different clinical features varied.

RESULTS

69.6% of the patients with Anti TIF1-γ were female. Prevalence of malignancy was 42.6% among patients with Anti TIF1-γ. Muscle weakness (83%), Gottron sign (82.2%), heliotrope rash (73.7%), nailfold capillary changes (67.7%), dysphagia (38.4%), and joint involvement (31.1%) were the most common clinical features seen in patients with Anti TIF1-γ. Interstitial lung disease (ILD) was reported among 8.7% of patients with Anti TIF1-γ. Advanced age, male gender, dysphagia, and V-neck rash were significant risk factors for malignancy, whereas juvenile age, ILD, TIF1-β antibodies and joint involvement were associated with a decreased risk for malignancy. Advanced age, malignancy, dysphagia, and muscle involvement were associated with an increased risk for mortality.

CONCLUSIONS

Patients with advanced age, male gender, dysphagia, and V-neck rash require strict cancer screening. Patients with advanced age, malignancy, dysphagia, and muscle involvement have poor prognosis and should receive aggressive treatment.

摘要

背景与目的

皮肌炎是一种主要影响皮肤和肌肉的慢性自身免疫性疾病。抗体是发病机制的关键因素,与不同的临床表型密切相关。我们报告了一例抗 TIF1 抗体阳性的皮肌炎患者,并对相关文献进行了全面回顾。

方法

检索 PubMed 和 Web of Science 数据库。共确定 166 篇文章,评估了 95 篇,其中 79 篇纳入研究。纳入的 45 篇文章为病例报告,9 篇为病例系列,25 篇为研究文章。共纳入 1065 例患者,但不同临床特征的患者数量有所不同。

结果

抗 TIF1-γ 患者中 69.6%为女性。抗 TIF1-γ 患者恶性肿瘤的患病率为 42.6%。肌肉无力(83%)、Gottron 征(82.2%)、向阳疹(73.7%)、甲褶毛细血管变化(67.7%)、吞咽困难(38.4%)和关节受累(31.1%)是抗 TIF1-γ 患者最常见的临床特征。8.7%的抗 TIF1-γ 患者出现间质性肺病(ILD)。高龄、男性、吞咽困难和 V 型颈疹是恶性肿瘤的显著危险因素,而青少年、ILD、TIF1-β 抗体和关节受累与恶性肿瘤风险降低相关。高龄、恶性肿瘤、吞咽困难和肌肉受累与死亡率增加相关。

结论

高龄、男性、吞咽困难和 V 型颈疹的患者需要严格进行癌症筛查。高龄、恶性肿瘤、吞咽困难和肌肉受累的患者预后不良,应给予积极治疗。

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