Sagües-Sesé Elena, García-Casares Natalia, Álvarez-Twose Ivan
Departamento de Medicina, Facultad de Medicina, Universidad de Málaga, Málaga, Spain.
Centro de Investigaciones Médico-Sanitarias (CIMES), Fundación General de la Universidad de Málaga, Universidad de Málaga, Málaga, Spain.
Clin Transl Allergy. 2023 Dec;13(12):e12319. doi: 10.1002/clt2.12319.
Mastocytosis manifests with multisystemic symptoms, often involving the nervous system. Numerous cognitive, neuropsychiatric and neurological alterations have been reported in multiple observational studies.
We performed a qualitative systematic literature review of reported data consulting the electronic databases Medline, Scopus, Web of Science, Cochrane, and BASE until June 2023.
We selected 24 studies in which the majority showed that a high proportion of mastocytosis patients suffer cognitive, neuropsychiatric and neurological alterations. The most common disorders and estimated ranges of frequency observed in adults were depression (68%-75%), anxiety, high stress or irritability (27%-54%), cognitive impairment (27%-39%, primarily affecting memory skills), and headaches (55%-69%). Attention challenges and learning difficulties were reported in children at a rate of 13%, while neurodevelopmental disorders occurred at rates of 8%-12%. Frequent white abnormalities in mastocytosis patients with concomitant psychocognitive symptoms have been reported although neuroimaging studies have been performed rarely in this population.
Further studies with more comprehensive and homogeneous evaluations and neuroimaging and histological analysis should be performed for a better understanding of these manifestations. An earlier detection and proper management of these symptoms could greatly improve the quality of life of these patients.
肥大细胞增多症表现为多系统症状,常累及神经系统。多项观察性研究报告了众多认知、神经精神和神经方面的改变。
我们对截至2023年6月通过检索电子数据库Medline、Scopus、Web of Science、Cochrane和BASE所获得的报告数据进行了定性系统文献综述。
我们筛选出24项研究,其中大多数研究表明,很大比例的肥大细胞增多症患者存在认知、神经精神和神经方面的改变。在成年人中观察到的最常见病症及其估计频率范围为抑郁症(68%-75%)、焦虑、高压力或易怒(27%-54%)、认知障碍(27%-39%,主要影响记忆技能)和头痛(55%-69%)。据报告,儿童出现注意力问题和学习困难的比例为13%,而神经发育障碍的发生率为8%-12%。尽管该人群很少进行神经影像学研究,但已有报告指出,伴有心理认知症状的肥大细胞增多症患者常出现白质异常。
应开展更全面、同质化评估以及神经影像学和组织学分析的进一步研究,以更好地了解这些表现。早期发现并妥善处理这些症状可极大提高这些患者的生活质量。