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儿童硬斑病免疫、骨骼及甲状腺功能异常的评估

Assessment of Immunological, Skeletal, and Thyroid Function Abnormalities in Paediatric Morphoea.

作者信息

Mendiratta Vibhu, Yadav Anuja, Meena Amit K, Samudrala Suvarna, Singh Ritu, Parmar Vishal

机构信息

From the Department of Dermatology and STD, Lady Hardinge Medical College, New Delhi, India.

Department of Dermatology and STD, SLBSGMCH, Mandi, Himachal Pradesh, India.

出版信息

Indian J Dermatol. 2025 Jan-Feb;70(1):50. doi: 10.4103/ijd.ijd_1081_23. Epub 2024 Dec 30.

Abstract

BACKGROUND

Morphoea is a sclerosing disorder of skin and subcutaneous tissue. Paediatric morphoea shows increased prevalence of various auto-immune diseases, bone deformities, and systemic abnormalities. There is paucity of studies on various immunological, skeletal, and thyroid function abnormalities in paediatric morphoea.

AIMS AND OBJECTIVES

To describe immunological, skeletal, and thyroid function abnormalities present in paediatric morphoea patients.

MATERIALS AND METHODS

This cross-sectional study was conducted from January 2021 to March 2023 in the Dermatology outpatient department in a tertiary care hospital. All paediatric morphoea patients were included in this study. All were subjected to detailed history, clinical examination, and investigations including complete blood count, serum IgE, anti-nuclear antibody, thyroid function tests, anti-thyroid peroxidase antibodies, and radiological investigations.

RESULTS

A total of 42 children were recruited, out of which 61.90% were females and 38.09% were males. The majority were in the age group of 4-8 years. The most common type of morphoea was encoup de sabre. Anaemia was present in 14.28% patients. Serum IgE levels were raised in 33.33% patients. Thyroid stimulating hormone was raised in 11.9% patients. 33.33% had raised anti-thyroid peroxidase levels. Anti-nuclear antibody titres and rheumatoid factor were raised in 7.14% and 4.76% patients, respectively. Magnetic resonance imaging brain revealed abnormalities in three patients as hyper-intensities in subcortical white matter.

CONCLUSION

Morphoea in children can be associated with varied immunological, osteoarticular, and neurological abnormalities. This study highlights the multi-system involvement in morphoea and the need for larger data and well-designed therapeutic trials for generating evidence-based treatment of this potentially disfiguring disease.

摘要

背景

硬斑病是一种皮肤和皮下组织的硬化性疾病。儿童硬斑病患者中各种自身免疫性疾病、骨骼畸形和全身异常的患病率增加。关于儿童硬斑病中各种免疫、骨骼和甲状腺功能异常的研究较少。

目的

描述儿童硬斑病患者存在的免疫、骨骼和甲状腺功能异常。

材料与方法

本横断面研究于2021年1月至2023年3月在一家三级医院的皮肤科门诊进行。所有儿童硬斑病患者均纳入本研究。所有患者均接受详细的病史询问、临床检查以及包括全血细胞计数、血清IgE、抗核抗体、甲状腺功能检查、抗甲状腺过氧化物酶抗体检查和影像学检查在内的各项检查。

结果

共招募了42名儿童,其中61.90%为女性,38.09%为男性。大多数患者年龄在4 - 8岁。最常见的硬斑病类型是剑状硬斑病。14.28%的患者存在贫血。33.33%的患者血清IgE水平升高。11.9%的患者促甲状腺激素升高。33.33%的患者抗甲状腺过氧化物酶水平升高。抗核抗体滴度和类风湿因子分别在7.14%和4.76%的患者中升高。脑部磁共振成像显示3例患者存在异常,表现为皮质下白质高信号。

结论

儿童硬斑病可能与多种免疫、骨关节和神经异常有关。本研究强调了硬斑病的多系统受累情况,以及需要更多数据和精心设计的治疗试验来为这种可能导致毁容的疾病提供循证治疗。

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本文引用的文献

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Update on Management of Morphea (Localized Scleroderma) in Children.儿童硬斑病(局限性硬皮病)管理的最新进展。
Indian Dermatol Online J. 2020 Mar 9;11(2):135-145. doi: 10.4103/idoj.IDOJ_284_19. eCollection 2020 Mar-Apr.
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Autoantibodies in Morphea: An Update.硬斑病中的自身抗体:最新进展。
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Morphea and antithyroid antibodies.硬斑病与抗甲状腺抗体
Postepy Dermatol Alergol. 2018 Oct;35(5):470-473. doi: 10.5114/ada.2018.75839. Epub 2018 Jul 19.
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Inflammatory arthritis in pediatric patients with morphea.儿童硬斑病患者的炎症性关节炎。
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Thyroid dysfunctions in morphoea: a preliminary report.硬斑病中的甲状腺功能障碍:初步报告。
Indian J Dermatol Venereol Leprol. 2014 Nov-Dec;80(6):579. doi: 10.4103/0378-6323.144230.

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