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包涵体肌炎合并干燥综合征。

Inclusion body myositis associated with Sjögren's syndrome.

机构信息

Department of Rheumatology and Internal Medicine, Academic Hospital Wroclaw, Borowska Street 213, Wrocław, Poland.

出版信息

Rheumatol Int. 2013 Dec;33(12):3083-6. doi: 10.1007/s00296-012-2556-4. Epub 2012 Dec 12.

Abstract

Inclusion body myositis (IBM) belongs to the group of idiopathic inflammatory myopathies. It is a poorly understood disease, which affects skeletal muscles. IBM usually occurs as an isolated condition, but in some cases, it may be associated with another autoimmune disorder, Sjögren's syndrome. We report a case of a 47-year-old woman with headaches, symptoms of trigeminal neuralgia, progressive weakness in muscles of the upper and lower extremities and symptoms of dry eyes and mouth. On admission, creatine kinase level was increased to 6,956 IU/mL and lactate dehydrogenase (LDH) to 1,011 U/L in the serum. The increase in inflammatory factor (CRP, ESR) levels was not found. The diagnosis of inclusion body myositis associated with Sjögren's syndrome was established on the basis of clinical picture and diagnostic tests. In this therapy, methotrexate and methylprednisolone were administered. The considerable improved muscle strength in the upper and lower extremities, improved speech and swallowing, disappearance of headache and reduction in CPK and LDH levels were found 8 months after establishing the diagnosis. Treatment with methotrexate and methylprednisolone improved the clinical symptoms and quality of life of this patient and may offer a therapeutic option for some patients with IBM and concomitant Sjögren's syndrome.

摘要

包涵体肌炎(IBM)属于特发性炎性肌病的一种。它是一种发病机制尚不完全清楚的疾病,主要影响骨骼肌。IBM 通常为孤立性疾病,但在某些情况下,它可能与另一种自身免疫性疾病,干燥综合征相关。我们报告了一例 47 岁女性,其出现头痛、三叉神经痛症状、四肢进行性无力以及眼干和口干的症状。入院时,血清肌酸激酶水平升高至 6956IU/ml,乳酸脱氢酶(LDH)升高至 1011U/L。未发现炎症因子(CRP、ESR)水平升高。根据临床表现和诊断性检查,诊断为包涵体肌炎合并干燥综合征。在治疗中,给予甲氨蝶呤和甲基强的松龙。在诊断后 8 个月,发现四肢的肌肉力量显著改善,言语和吞咽功能改善,头痛消失,CPK 和 LDH 水平降低。甲氨蝶呤和甲基强的松龙的治疗改善了该患者的临床症状和生活质量,并且可能为一些 IBM 合并干燥综合征患者提供治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/480f/3832753/2aa3294f374a/296_2012_2556_Fig1_HTML.jpg

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