Aviña-Zubieta J A, Galindo-Rodriguez G, Lavalle C
Departamento de Reumatologia, Hospital de Especialidades Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Colonia La Raza, México, D.F., Mexico.
Curr Opin Rheumatol. 1998 Jan;10(1):86-90. doi: 10.1097/00002281-199801000-00013.
A review of the literature during the past year on rheumatic manifestations in hematologic diseases supports the idea that 80% of the hemorrhage in hemophilia occurs within the joints, with knees, elbows, and ankles being the most affected joints in adults. In contrast, the ankle is the target joint in children. Septic arthritis in hemophilic patients is becoming more important due to the advent of HIV infection. Radioactive synoviorthesis in hemarthrosis has the same rate of success as surgical synovectomy, but with far lower costs. A new study documents the association of arthritis and vasculitis in patients with myelodysplasic syndromes and lymphoproliferative disorders. An increased incidence of scoliosis in patients with beta-thalassemia has been noted. Finally, the effects of bone marrow transplantation in patients with previous autoimmune diseases is reviewed. Progression of rheumatoid arthritis after bone marrow transplantation is documented in a patient with 13 years of follow-up. Hematologic disorders in rheumatic diseases are not the topic of this review.
血友病患者80%的出血发生在关节内，在成人中，膝关节、肘关节和踝关节是受影响最严重的关节。相比之下，踝关节是儿童的靶关节。由于HIV感染的出现，血友病患者的化脓性关节炎正变得越来越重要。放射性滑膜切除术治疗关节积血的成功率与手术滑膜切除术相同，但成本要低得多。一项新研究记录了骨髓增生异常综合征和淋巴增殖性疾病患者中关节炎与血管炎的关联。已注意到β地中海贫血患者脊柱侧弯的发病率增加。最后，综述了骨髓移植对既往有自身免疫性疾病患者的影响。一名患者经13年随访记录了骨髓移植后类风湿关节炎的进展。风湿性疾病中的血液系统疾病不是本综述的主题。
