透過您的圖書館登入
IP:216.73.216.183
  • 期刊

肥大細胞增多症—容易被忽略的疾病

摘要


肥大細胞增多症是一種罕見疾病,在亞太地區發生率尤其低。回顧過去在臺北榮民總醫院診斷的肥大細胞增多症病例只有22例(全身性14例,皮膚性8例)。多數(11/14)全身性肥大細胞增多症患者患有血液腫瘤。CD30免疫染色在57%(8/14)的全身性肥大細胞增多症病例和100%(7/7)的皮膚肥大細胞增多症病例中呈陽性。CD123則僅在3例全身性肥大細胞增多症伴隨相關血液腫瘤及1例全身性肥大細胞增多症病例中局部或弱表現。雖然本院的肥大細胞增多症病例亞型的分佈以及CD30和CD123的表現與北美和歐洲報告的不盡相同,但由於肥大細胞增多症相當罕見,多數醫師並不熟悉此疾病;再者肥大細胞增多症尤其是惰性肥大細胞增多症,其臨床表現具多樣性和非特異性而容易被忽略。都可能是未安排患者接受包括骨髓切片等相關檢查,而無法診斷的原因。另一方面,由於血液腫瘤常需要骨髓檢查,因而意外發現全身性肥大細胞增多症,使得本院患者同時患有血液腫瘤比例較高。所以本文目的在於藉由本院的病例,使得醫師熟悉此疾病,能高度懷疑和改進診斷方法,幫助肥大細胞增多症患者獲得正確的診斷。

參考文獻


Khoury JD, Solary E, Abla O, et al. The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Myeloid and Histiocytic/Dendritic Neoplasms. Leukemia 2022;36:1703-19."
Lim KH, Tefferi A, Lasho TL, et al. Systemic mastocytosis in 342 consecutive adults: survival studies and prognostic factors. Blood 2009;113:5727-36."
Arber DA, Orazi A, Hasserjian RP, et al. International Consensus Classification of Myeloid Neoplasms and Acute Leukemias: integrating morphologic, clinical, and genomic data. Blood 2022;140:1200-28."
Martelli M, Monaldi C, De Santis S, et al. Recent Advances in the Molecular Biology of Systemic Mastocytosis: Implications for Diagnosis, Prognosis, and Therapy. Int J Mol Sci 2020;21."
Borate U, Mehta A, Reddy V, et al. Treatment of CD30-positive systemic mastocytosis with brentuximab vedotin. Leuk Res. 2016;44:25-31."

延伸閱讀