Bolster Lauren, Taylor-Gjevre Regina M, Nair Bindu, Gjevre John A
Division of Rheumatology, Department of Internal Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
J Med Case Rep. 2010 Jun 22;4:189. doi: 10.1186/1752-1947-4-189.
Anticentromere antibodies have been associated with peripheral vascular occlusive disease, most frequently accompanied by sclerodactyly in the context of a connective tissue disorder. We report a case of digital gangrene with no other clinical associations except positive anticentromere antibodies.
Our patient, a 53-year-old Caucasian woman, non-smoker, presented with progressive pain and blackening of the distal right third finger over the preceding five weeks. No sclerodactyly was evident. She was anticentromere antibody positive at greater than 100 U/mL. Angiography revealed diffuse distal vasculopathy in both upper extremities. Other investigations were unremarkable.
It is rare for anticentromere antibody-associated digital necrosis to develop without concomitant sclerodactyly. However, this patient's case illustrates the need to consider an autoimmune contribution to the pathogenesis of digital ischemia even in the absence of a recognizable connective tissue disease.
抗着丝点抗体与周围血管闭塞性疾病有关,在结缔组织疾病的背景下,最常伴有指端硬化。我们报告一例除抗着丝点抗体阳性外无其他临床关联的指端坏疽病例。
我们的患者是一名53岁的白种女性,不吸烟,在过去五周内出现右手中指远端进行性疼痛和变黑。未发现指端硬化。她的抗着丝点抗体阳性,大于100 U/mL。血管造影显示双上肢弥漫性远端血管病变。其他检查无异常。
抗着丝点抗体相关的指端坏死在无指端硬化的情况下发生是罕见的。然而,该患者的病例表明,即使在没有可识别的结缔组织疾病的情况下,也需要考虑自身免疫在指端缺血发病机制中的作用。