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系统性红斑狼疮患者并发致命性急性胰腺炎及胰腺假性囊肿。

Fatal acute pancreatitis complicated by pancreatic pseudocysts in a patient with systemic lupus erythematosus.

机构信息

Unidad de Enfermedades Autoinmunes Sistémicas, Facultad de Medicina, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay.

出版信息

Rheumatol Int. 2010 Mar;30(5):675-8. doi: 10.1007/s00296-009-0964-x. Epub 2009 May 23.

Abstract

Pancreatitis is a relatively rare but severe manifestation in systemic lupus erythematosus (SLE) patients. We report a case of a 39-year-old woman with previous SLE diagnose treated with prednisone and mycophenolate mofetil who developed an acute pancreatitis complicated by pancreatic pseudocysts within the context of a severe lupus flare. Elevated serum amylase and computerized tomography confirmed the diagnosis and mechanical obstruction or toxic-metabolic etiologies were ruled out. In the present case, we opted for the clinical surveillance of pancreatic pseudocyst and not perform invasive medical procedures to drainage. A steroid therapy was started in order to achieve SLE and pancreatitis remission, however, it was unable to avoid the development of multiorgan failure and patient died a few days after diagnosis was made.

摘要

胰腺炎是系统性红斑狼疮(SLE)患者中相对罕见但严重的表现。我们报告了一例 39 岁的女性,既往诊断为 SLE,接受泼尼松和吗替麦考酚酯治疗,在严重狼疮发作的情况下发生急性胰腺炎,并伴有胰腺假性囊肿。血清淀粉酶升高和计算机断层扫描(CT)证实了诊断,并排除了机械性梗阻或中毒代谢性病因。在本例中,我们选择对胰腺假性囊肿进行临床监测,而不进行有创性的引流治疗。为了实现 SLE 和胰腺炎的缓解,我们开始使用类固醇治疗,但仍无法避免多器官衰竭的发生,患者在诊断后几天死亡。

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