欧洲抗风湿病联盟及美国风湿病学会关于IL-1介导的自身炎症性疾病(CAPS、TRAPS、MKD和DIRA)诊疗指南解读

Interpretation on the 2021 EULAR/American College of Rheumatology Points to Consider for Diagnosis, Management and Monitoring of the Interleukin-1 Mediated Autoinflammatory Diseases: Cryopyrin-Associated Periodic Syndromes, Tumour Necrosis Factor Receptor-Associated Periodic Syndrome, Mevalonate Kinase Deficiency, and Deficiency of the Interleukin-1 Receptor Antagonist

  • 摘要: 白细胞介素1(interleukin-1,IL-1)介导的自身炎症性疾病是以IL-1生成增多或通路激活为特征的一大类自身炎症性疾病,主要包括家族性地中海热、冷炎素相关周期性综合征、肿瘤坏死因子受体相关周期性综合征、甲羟戊酸激酶缺乏症以及IL-1受体抑制剂缺陷。此类疾病起病早,受累器官广泛,若未经有效治疗,可导致进行性器官损伤、多种并发症甚至死亡。2016年,欧洲抗风湿病联盟已发布针对家族性地中海热的诊疗推荐意见。为提高该类疾病的诊断能力、治疗及长期管理效果,欧洲抗风湿病联盟及美国风湿病学会于2022年共同发布了针对其他4类疾病的诊疗指南。本文将详细介绍该指南要点,以期指导临床实践。

     

    Abstract: Interleukin-1 mediated autoinflammatory diseases, a large class of autoinflammatory diseases characterized by increased release of interleukin-1 or activation of the interleukin-1 pathway, mainly include familial Mediterranean fever, cryopyrin-associated periodic syndrome, tumor necrosis factor receptor associated periodic syndrome, mevalonate kinase deficiency syndrome and deficiency of the interleukin-1 receptor antagonist. These diseases present in early childhood and affect multiple systems, which, if untreated, may result in progressive organ damage, morbidity and mortality. In 2016, European Alliance of Associations for Rheumatology (EULAR) published recommendations for familial Mediterranean fever. For the latter four types of diseases, EULAR and the American College of Rheumatology developed several points in terms of diagnosis, management and monitoring in 2022. This article aims to introduce the application of these points.

     

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