Suppr超能文献

[周围神经免疫性疾病——神经病理学见解与临床展望]

[Peripheral neuroimmunological diseases - Neuropathological insights and clinical perspectives].

作者信息

Hoffmann Sarah, Holzer Marie-Therese, Preuße Corinna, Ruck Tobias, Ruffer Nikolas, Stascheit Frauke, Stenzel Werner

机构信息

Klinik für Neurologie, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, und Berlin Institute of Health (BIH), Charité-Universitätsmedizin, Berlin, Deutschland.

III. Medizinische Klinik und Poliklinik, Sektion Rheumatologie und entzündliche Systemerkrankungen, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.

出版信息

Nervenarzt. 2024 Oct;95(10):920-931. doi: 10.1007/s00115-024-01725-2. Epub 2024 Sep 20.

Abstract

This article deals with peripheral neuroimmunological diseases and briefly outlines the currently most important aspects and treatment developments. Idiopathic inflammatory myopathies have different mechanisms of development, manifestations and prognoses. New classification systems and more specific treatment concepts have been developed. The IIMs include different subgroups. These entities can have specific autoantibodies. Diagnostically, a muscle biopsy is generally desirable for a precise diagnosis and is essential in unclear cases. Primary systemic vasculitides can be divided into different groups based on the predominant pattern of involvement, while secondary vasculitides and single organ vasculitides are also differentiated. Vasculitic myopathy cannot be equated with myositis and a reliable distinction is currently only possible by a muscle biopsy. Treatment concepts should be developed on an interdisciplinary basis. Chronic inflammatory demyelinating polyneuropathy is the most frequent immune-mediated neuropathy and is characterized by a predominant demyelination of the motor and sensory nerves. The disease course runs in phases or is progressive and leads to significant disability and reduction in quality of life, despite current standard treatment. Novel treatment approaches are currently undergoing clinical trials. Myasthenia gravis, with the leading symptom of exercise-induced muscle weakness, is caused by autoantibodies against structures of the neuromuscular endplate. Autoantibody testing is the most important pillar in the diagnosis and is now also increasingly guiding treatment decisions. Overall, peripheral neuroimmunological diseases represent a heterogeneous group. Increasing knowledge of the pathophysiology is the key to numerous developments in diagnostics and treatment, which could lead to far-reaching practical changes in the future.

摘要

本文论述周围神经免疫性疾病,并简要概述了当前最重要的方面及治疗进展。特发性炎性肌病具有不同的发病机制、临床表现和预后。现已形成新的分类系统和更具针对性的治疗理念。特发性炎性肌病包括不同的亚组。这些疾病实体可能具有特定的自身抗体。在诊断方面,通常需要进行肌肉活检以获得精确诊断,在诊断不明确的病例中这是必不可少的。原发性系统性血管炎可根据主要受累模式分为不同组,同时也对继发性血管炎和单器官血管炎进行区分。血管炎性肌病不能等同于肌炎,目前只有通过肌肉活检才能可靠地区分。治疗理念应在多学科基础上制定。慢性炎性脱髓鞘性多发性神经病是最常见的免疫介导性神经病,其特征是运动和感觉神经主要发生脱髓鞘。尽管有当前的标准治疗方法,但该病病程呈阶段性或进行性发展,会导致严重残疾和生活质量下降。目前新的治疗方法正在进行临床试验。重症肌无力以运动诱发的肌肉无力为主要症状,由针对神经肌肉终板结构的自身抗体引起。自身抗体检测是诊断的最重要支柱,现在也越来越多地指导治疗决策。总体而言,周围神经免疫性疾病是一组异质性疾病。对病理生理学认识的不断提高是诊断和治疗众多进展的关键,这可能在未来带来深远的实际变化。

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验