Kubo Norihiko, Sawayama Yasunori, Okada Kyoko, Nakagawa Yoshifumi, Asou Yoshihiro, Nabeshima Shigeki, Otsuka Takeshi, Kashiwagi Seizaburo, Hayashi Jun
Department of Environmental Medicine and Infectious Diseases, Kyushu University Graduated School of Medical Sciences, Fukuoka-city.
Ryumachi. 2002 Aug;42(4):676-81.
A 24-year-old Japanese woman was admitted to our hospital in January 2000 with daily diarrhea, abdominal distention, and abdominal pain. Raynaud's phenomenon with erythroderma desquamativum eruptions had been found in 1992. In 1999, small intestinal transillumination showed dilation of the second and third portion of the duodenum. She was diagnosed as amyopathic dermatomyositis because of Gottron's sign despite not having symptoms of myositis, normal serum CPK levels and no histological abnormality by muscle biopsy. In addition, the patient was diagnosed as systemic sclerosis sine scleroderma because Raynaud's phenomenon, leukoma and gastrointestinal dilation were present. Also, antinuclear antibody and anti centromere antibody were positive and anti Scl-70 antibody was dull-positive, despite the absence of scleroderma, extreme edema, and bone resorption. Careful, long term observation will be required because of the splanchnopathy in youth and the complications of systemic sclerosis.
一名24岁的日本女性于2000年1月入院,伴有每日腹泻、腹胀和腹痛。1992年发现有雷诺现象伴脱屑性红皮病皮疹。1999年,小肠透照显示十二指肠第二和第三部分扩张。尽管没有肌炎症状、血清肌酸磷酸激酶水平正常且肌肉活检无组织学异常,但因Gottron征,她被诊断为无肌病性皮肌炎。此外,由于存在雷诺现象、白斑和胃肠道扩张,该患者被诊断为无硬皮病的系统性硬化症。而且,尽管没有硬皮病、极度水肿和骨吸收,但抗核抗体和抗着丝点抗体呈阳性,抗Scl - 70抗体弱阳性。由于青年期内脏病和系统性硬化症的并发症,需要进行仔细的长期观察。