Le syndrome des abcès aseptiques

Abstract

Aseptic abscesses syndrome is a systemic disorder of unknown etiology involving polymorphonuclear neutrophil. Typical presentation of aseptic abscesses syndrome includes fever, abdominal pain and leukocytosis, and is characterized by the presence of intra-abdominal aseptic lesions consisting of neutrophils. The diagnosis relies on a combination of a typical clinical and radiological presentation, the pathological findings, and the exclusion of alternative diagnosis, especially infectious diseases. Antibiotics fail to achieve cure but there is a marked improvement with corticosteroids. Aseptic abscesses syndrome is either associated with another disease such as Crohn's disease or relapsing polychondritis, or is idiopathic. It is often a relapsing condition and the PET may be an interesting diagnostic tool in the setting of recurrent and febrile abdominal pain. An immunosuppressive agent is required in almost half of the patients and anti-TNFα drugs may be used. Aseptic abscesses syndrome shares some features with other disorders such as inflammatory bowel diseases or neutrophilic dermatoses which suggests a genetic susceptibility and a relationship with auto-inflammatory disorders. Further studies on the pathways involved in aseptic abscesses will help to improve diagnosis and treatment.