Asanuma Yu, Koichihara Reiko, Koyama Shinichiro, Kawabata Yoshinori, Kobayashi Shio, Mimori Tsuneyo, Moriguchi Masato
Clinical Department of Internal Medicine, Jichi Medical School Omiya Medical Center, Saitama.
Intern Med. 2006;45(18):1065-8. doi: 10.2169/internalmedicine.45.1772. Epub 2006 Oct 16.
A 30-year-old man complained of polyarthralgia and fatigue. The clinical findings and laboratory data included myositis, polyarthritis, interstitial pneumonia, Raynaud's phenomenon, mechanic's hand, and anti PL-7 antibody (threonyl-tRNA synthetase antibody). All of these signs were consistent with antisynthetase syndrome. His chest radiograph revealed bilateral hilar lymphadenopathy. Biopsy specimens from his mediastinal lymph node and muscle showed noncaseating epithelioid cell granulomas. Lung histology revealed nonspecific interstitial pneumonia. Antisynthetase syndrome associated with sarcoidosis was diagnosed. Interstitial pneumonia in this patient responded well to high-dose corticosteroid therapy.
一名30岁男性主诉多关节痛和疲劳。临床检查结果及实验室数据包括肌炎、多关节炎、间质性肺炎、雷诺现象、技工手以及抗PL-7抗体(苏氨酰-tRNA合成酶抗体)。所有这些体征均符合抗合成酶综合征。他的胸部X光片显示双侧肺门淋巴结肿大。纵隔淋巴结和肌肉的活检标本显示非干酪样上皮样细胞肉芽肿。肺部组织学检查显示非特异性间质性肺炎。诊断为与结节病相关的抗合成酶综合征。该患者的间质性肺炎对大剂量皮质类固醇治疗反应良好。