A Contemporary Update on the Diagnosis of Systemic Lupus Erythematosus
A Contemporary Update on the Diagnosis of Systemic Lupus Erythematosus
复制标题
系统性红斑狼疮诊断的当代最新进展
DOI：
10.1007/s12016-021-08917-7
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发表时间：
2022-01-22
影响因子：
9.1
通讯作者：
Lu, Qianjin
中科院分区：
文献类型：
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作者：
Huang, Xin;Zhang, Qing;Lu, Qianjin
系统性红斑狼疮（SLE）是一种复杂的自身免疫性疾病，女性易感。其特点是免疫系统过度激活，自身免疫复合物在多器官沉积。SLE的高异质性、不可预测的病程以及缺乏特异性和敏感性的生物标志物给临床医生带来了诊断挑战。尽管SLE的临床表现和发病机制复杂，但在过去的几十年里，对该病的研究取得了许多重大突破。一些新的知识可以潜在地转化为临床实践。此外，欧洲抗风湿病联盟/美国风湿病学会（EULAR/ACR）在2019年定义了新的分类标准，以提高诊断准确性。现实世界的研究已经为采用这一新的分类标准积累了证据。丰富的分类标准，提高了对器官特异性表现的认识，以及更新了对狼疮自身抗体的认识，使狼疮的早期诊断和更个性化的治疗成为可能。因此，更新我们关于狼疮诊断的最新临床实践的知识是很重要的。本文综述了近年来在流行病学、病因学、分类标准、临床表现和自身抗体研究方面的进展，为SLE的诊断提供了新的见解。
Systemic lupus erythematosus (SLE) is a complicated autoimmune disease with female susceptibility. It is characterized by over-activation of the immune system and deposit of autoimmune complex in multiple organs. High heterogeneity, unpredictable disease course of SLE as well as the lack of specific and sensitive biomarkers posed diagnostic challenges to clinicians. Despite the complicated clinical presentation and pathogenesis of SLE, research regarding this disease has made many significant breakthroughs over the past decades. Some new learning can potentially be translated into clinical practice. In addition, new classification criteria to increase diagnostic accuracy were defined in 2019 by the European League Against Rheumatism/American College of Rheumatology (EULAR/ACR). Real-world studies have accumulated evidence for the adoption of this new classification criteria. Abundant classification criteria, improved recognition of organ-specific manifestations, and updated knowledge about lupus autoantibodies enable earlier diagnosis and more personalized medicine. Thus, it is important to update our knowledge about the latest clinical practices for lupus diagnosis. This review provides new insight into the diagnosis of SLE by summarizing recent advances in epidemiology, etiology, classification criteria, clinical manifestations, and study of autoantibodies.