Klingel R, Poralla T, Dippold W, Meyer zum Büschenfelde K H
I. Medizinische Klinik und Poliklinik, Universität Mainz.
Dtsch Med Wochenschr. 1990 Dec 14;115(50):1911-6. doi: 10.1055/s-2008-1065243.
A 72-year-old woman, not previously known to have coronary heart disease, was admitted to hospital with an acute anterior wall myocardial infarction. The history revealed that, when about 40 years of age, a coarse skin-fold and yellowish-white xanthoma-like efflorescences had been noted around her umbilicus, the inguinal regions and axillae. These changes subsequently developed into a pathognomonic picture of pseudoxanthoma elasticum (PE), which was a significant factor in the myocardial infarction. At the age of 69 years, rheumatoid arthritis (RA), stage II after Steinbrocker, had been diagnosed on the basis of morning stiffness, symmetrical arthritis in more than three joint regions and the radiological appearance of narrowed joint spaces with erosions. Different pathological mechanisms of PE and RA change the connective tissue metabolism, thus affecting the same target tissue, but there is no known connection between the two diseases.
一名72岁女性,既往无冠心病史,因急性前壁心肌梗死入院。病史显示,她大约40岁时,脐周、腹股沟区和腋窝周围出现了粗糙的皮肤褶皱和黄白色的类黄瘤样皮疹。这些变化随后发展为弹性假黄瘤(PE)的典型表现,这是心肌梗死的一个重要因素。69岁时,根据晨僵、三个以上关节区域的对称性关节炎以及关节间隙变窄伴侵蚀的放射学表现,诊断为Steinbrocker II期类风湿关节炎(RA)。PE和RA不同的病理机制改变了结缔组织代谢,从而影响相同的靶组织,但这两种疾病之间尚无已知联系。