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VEXAS syndrome in adults: A narrative review of genomic pathogenesis, multisystem phenotypes, diagnostic algorithms, and emerging therapeutic strategies - PubMed

4 hours ago
  • #autoinflammatory disorder
  • #VEXAS syndrome
  • #UBA1 mutation
  • VEXAS syndrome is an adult-onset autoinflammatory disorder caused by somatic mutations in the UBA1 gene.
  • Primarily affects older males, with over 300 cases reported since its identification in 2020.
  • Clinical phenotypes include relapsing polychondritis, cytopenias, neutrophilic dermatoses, and overlap with myelodysplastic syndromes.
  • Diagnosis is confirmed by detecting somatic mutations in UBA1, most commonly at codon 41.
  • Treatment responses vary; corticosteroids are used initially, but JAK inhibitors, hypomethylating agents, or hematopoietic stem-cell transplantation show longer-lasting benefits.
  • Therapeutic decision-making remains empirical due to lack of controlled trials.
  • Early molecular diagnosis and genotype-informed treatment strategies are critical.
  • Collaborative, prospective studies are needed to refine diagnostic algorithms and optimize therapeutic outcomes.