儿童干扰素病的影像学表现
儿童干扰素病由I型干扰素通路异常激活引起,呈自身炎症-自身免疫连续谱,影像可累及脑、肺、血管、骨骼等多系统。本文综述其临床、影像与病理特征,指出各病虽有独特表现,但常共享反映共同病理生理的影像模式。
要点
- 儿童干扰素病可多系统受累,脑病、血管病变和间质性肺病提示诊断。
- Aicardi-Goutières综合征与先天性TORCH感染的影像相似,需注意鉴别。
- 各干扰素病影像表现虽有差异,但共享反映共同病理生理的模式。
核心结论
- 干扰素病提供跨越自身炎症-自身免疫连续谱的免疫介导疾病新框架。
- 各病有独特影像表现,但许多共享反映共同病理生理的共同模式。
研究设计与样本
- 综述,概述儿童干扰素病的临床、影像和病理特征。
关键影像表现/征象
- 脑病、血管病变、间质性肺病及骨骼改变等可呈不同组合。
- Aicardi-Goutières综合征与先天性TORCH感染的影像表现相似。
临床应用与阅片要点
- 对脑病、间质性肺病或血管病变患儿,应结合皮肤、自身免疫等表现考虑干扰素病。
- 遇到类似先天性TORCH感染的影像但感染证据阴性时,需警惕Aicardi-Goutières综合征。
以上解读依据论文摘要(全文未开放获取或许可不允许翻译转载)。
英文原文(摘要)· 点击展开
Type I interferon (IFN-I) is a proinflammatory cytokine that activates signalling pathways crucial for antiviral defence in innate immunity. The IFN-I system is a self-preserving mechanism that normally responds to exogenous nucleic acids derived from pathogens, but not to endogenous nucleic acids from host cells. However, genetic defects that constitutively activate this pathway can lead to aberrant IFN-I production (the "IFN signature") and sterile inflammation (autoinflammation), giving rise to a group of monogenic disorders collectively termed "autoinflammatory interferonopathies." This emerging perspective was initially prompted by the phenotypic similarities between Aicardi-Goutières syndrome and congenital toxoplasmosis, other infections, rubella, cytomegalovirus, and herpes simplex (TORCH) infection. Autoinflammatory interferonopathies can manifest with variable combinations of cutaneous changes, encephalopathy, vasculopathy, interstitial lung disease, and other features (e.g., skeletal changes), and are commonly accompanied by autoimmunity. More recently, the IFN signature has also attracted attention in autoimmune diseases such as systemic lupus erythematosus and dermatomyositis, which have been increasingly referred to as "autoimmune interferonopathies." Collectively, interferonopathies provide a novel framework for immune-mediated diseases spanning an autoinflammatory-autoimmune continuum. Here, we outline the clinical, imaging, and pathogenic features of paediatric interferonopathies. While each disorder has distinctive imaging findings, many share common patterns reflecting common underlying pathophysiology.
引用
- Tsujioka Y, Nishimura G, Hattori S, et al. Imaging findings in pediatric interferonopathies. Pediatr Radiol. 2026. PMID: 42176059. doi:10.1007/s00247-026-06642-x
供执业医师工作参考,不替代临床判断;数值与分级以指南原文为准。