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确定自身炎症性复发性发热分子病因的尝试。

Attempts to identify the molecular cause of autoinflammatory recurrent fever.

作者信息

Boyarchuk Oksana, Savkiv Diana

机构信息

Department of Children's Diseases and Pediatric Surgery, I. Horbachevsky Ternopil National Medical University, Ukraine.

出版信息

Reumatologia. 2024;62(5):381-388. doi: 10.5114/reum/193903. Epub 2024 Nov 8.

Abstract

Systemic autoinflammatory diseases caused by dysregulation of the innate immunity are a known cause of recurrent fevers. We present the molecular diagnosis results of 12 children with recurrent fever, analyzing the correlation between molecular findings and clinical symptoms. No pathogenic variants confirming autoinflammatory disease were found. One child was diagnosed with SRP54 deficiency, linked to congenital neutropenia with a cyclic pattern. Variants of uncertain significance were found in 6 patients in genes associated with autoinflammatory disorders, though two lacked clinical correlation. Variants of uncertain significance in the gene were detected in 2 patients with periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrome, in the gene in 1 child with systemic juvenile idiopathic arthritis, and in the gene in 1 patient with syndrome of uncertain recurrent fever. COVID-19 was identified as a triggering factor in 54.5% of cases. Further research is needed to clarify the role of genetic variants and environmental factors in recurrent fevers.

摘要

由先天免疫失调引起的全身性自身炎症性疾病是反复发热的已知原因。我们展示了12例反复发热儿童的分子诊断结果,分析了分子检测结果与临床症状之间的相关性。未发现确诊自身炎症性疾病的致病变体。一名儿童被诊断为SRP54缺乏症,与周期性先天性中性粒细胞减少症有关。在与自身炎症性疾病相关的基因中,6例患者发现了意义未明的变体,不过其中两例与临床无关。在2例周期性发热、口疮性口炎、咽炎、腺炎(PFAPA)综合征患者的基因中、1例系统性幼年特发性关节炎患儿的基因中以及1例不明原因反复发热综合征患者的基因中检测到意义未明的变体。54.5%的病例中,COVID-19被确定为触发因素。需要进一步研究以阐明基因变体和环境因素在反复发热中的作用。

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