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布劳综合征(青少年系统性肉芽肿病):最新综述

Blau Syndrome (Juvenile Systemic Granulomatosis): State-Of-The-Art Review.

作者信息

Wang Ou Jia Emilie, Jacob Marianna, Crawford Richard I, Lam Joseph M

机构信息

Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

Department Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.

出版信息

Pediatr Dermatol. 2025 Jul-Aug;42(4):728-734. doi: 10.1111/pde.16001. Epub 2025 Jun 2.

Abstract

Blau syndrome (BlauS) is a rare pediatric autoinflammatory disorder due to NOD2 gain-of-function pathogenic variants characterized by a triad of granulomatous dermatitis, arthritis, and uveitis, which can progress to systemic complications if untreated. Skin and joint findings typically emerge by age 2 years, with ocular involvement appearing around age 4 years. Early biologic intervention, particularly with anti-TNF-α therapies, can prevent severe complications like joint destruction and blindness. Systemic corticosteroids serve as bridging therapy, while methotrexate and thalidomide may help but are often insufficient as monotherapy. IL-1 and IL-6 inhibitors, as well as tofacitinib, are options for refractory cases.

摘要

布劳综合征(BlauS)是一种罕见的儿童自身炎症性疾病,由NOD2功能获得性致病变异引起,其特征为肉芽肿性皮炎、关节炎和葡萄膜炎三联征,若不治疗可进展为全身并发症。皮肤和关节症状通常在2岁时出现,眼部受累约在4岁左右出现。早期生物干预,尤其是抗TNF-α治疗,可以预防关节破坏和失明等严重并发症。全身用皮质类固醇作为过渡治疗,而甲氨蝶呤和沙利度胺可能有帮助,但作为单一疗法往往不够。IL-1和IL-6抑制剂以及托法替布是难治性病例的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c6d/12285560/25292bdc11da/PDE-42-728-g001.jpg

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