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儿童 I 型干扰素病:大患者队列中的共性和多样性。

Children With Type I Interferonopathy: Commonalities and Diversities in a Large Patient Cohort.

机构信息

F. Haslak, MD, S. Sahin, MD, B. Hotaman, MD, N.M. Cebi, MD, M. Yildiz, MD, A. Adrovic, MD, A. Gunalp, MD, E. Kilic Konte, MD, E. Aslan, MD, U. Gul, MD, N. Akay, MD, K. Barut, MD, O. Kasapcopur, MD, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Department of Pediatric Rheumatology.

H. Kilic, MD, Y. Zindar, MD, F. Ulug, MD, S. Guler, MD, S. Saltik, MD, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Department of Pediatric Neurology.

出版信息

J Rheumatol. 2024 Dec 1;51(12):1208-1217. doi: 10.3899/jrheum.2024-0294.

Abstract

OBJECTIVE

This study aimed to provide a comprehensive overview of the clinical features, laboratory and screening results, treatment options, and outcomes of patients with type I interferonopathy. Our secondary goal was to identify the predictors of long-term morbidity or mortality.

METHODS

We included children with genetically confirmed type I interferonopathies, with a follow-up duration of > 1 year. Data were obtained retrospectively from medical records.

RESULTS

Of the 40 eligible patients for the study, 52.5% were female, with a median age of disease onset of 1.5 years (range 0.1-13.2 yrs). They were diagnosed at an average age of 6.8 (SD 4.6) years. Aicardi-Goutières syndrome was the most common diagnosis (n = 15, 37.5%). The central nervous system was the most frequently affected system (n = 27, 67.5%). Janus kinase inhibitors were administered to 17 (42.5%) patients. Twenty-five patients (62.5%) developed at least 1 permanent morbidity or died during follow-up; thus, they were included in the poor outcome group. Although younger age at disease onset, intracranial calcification (ICC), and lack of chilblains and elevated acute-phase reactants were significant in univariate logistic regression analysis, only ICC on magnetic resonance imaging at admission (adjusted odds ratio 19.69, 95% CI 1.08-359.05, = 0.04) was found to be a significant predictor of poor outcomes in multivariate logistic regression analysis.

CONCLUSION

For the first time, we evaluated the predictors of poor outcomes in patients with type I interferonopathy with a broad spectrum of subtypes. Further, our study's unique patient characteristics can provide valuable insights into these extremely rare conditions.

摘要

目的

本研究旨在全面概述 1 型干扰素病患者的临床特征、实验室和筛查结果、治疗选择和转归。我们的次要目标是确定长期发病或死亡的预测因素。

方法

我们纳入了经基因证实患有 1 型干扰素病且随访时间> 1 年的儿童患者。数据从病历中回顾性获得。

结果

在符合研究条件的 40 名患者中,52.5%为女性,疾病发病中位年龄为 1.5 岁(范围 0.1-13.2 岁)。他们的平均诊断年龄为 6.8(SD 4.6)岁。Aicardi-Goutières 综合征是最常见的诊断(n = 15,37.5%)。中枢神经系统是最常受影响的系统(n = 27,67.5%)。17 名(42.5%)患者接受了 Janus 激酶抑制剂治疗。25 名患者(62.5%)在随访期间至少出现 1 种永久性发病或死亡,因此被纳入不良结局组。虽然疾病发病年龄较小、颅内钙化(ICC)、无冻疮和急性期反应物升高在单变量逻辑回归分析中具有显著意义,但只有入院时磁共振成像上的 ICC(调整后的优势比 19.69,95%置信区间 1.08-359.05,= 0.04)在多变量逻辑回归分析中被发现是不良结局的显著预测因素。

结论

我们首次评估了具有广泛亚型的 1 型干扰素病患者不良结局的预测因素。此外,我们研究的独特患者特征可为这些极为罕见的疾病提供有价值的见解。

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