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[白塞病患者的耳鼻喉科表现]

[Otorhinolaryngological manifestations in patients with Behçet disease].

作者信息

Morales-Angulo Carmelo, Vergara Pastrana Sandra, Obeso-Agüera Sergio, Acle Leticia, González-Gay Miguel Ángel

机构信息

Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander, España.

Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander, España.

出版信息

Acta Otorrinolaringol Esp. 2014 Jan-Feb;65(1):15-21. doi: 10.1016/j.otorri.2013.06.007. Epub 2013 Oct 2.

Abstract

INTRODUCTION AND OBJECTIVES

Behçet disease (BD) is a systemic immune-mediated vasculitis of unknown origin characterised by recurrent orogenital ulceration, ocular inflammation and skin lesions. The aim of our study was to identify ear, nose and throat (ENT) manifestations associated with BD.

PATIENTS AND METHODS

Retrospective review of the medical records of all patients diagnosed with BD who attended a tertiary public hospital in Cantabria (Spain) over a period of 22 years. Clinical manifestations, in particular those concerning ENT, were retrieved from medical records. A medical literature review of ENT manifestations was conducted.

RESULTS

Thirty-three patients (age range: 17-64 years) were included in the study. Most of them presented oral ulcers (97%). Eight patients (24%) presented oropharyngeal ulcers and 5 patients (15%) experienced audiovestibular symptoms (high frequency sensorineural hearing loss, vertigo and bilateral vestibular hypofunction). One patient had symptoms compatible with vestibular neuronitis as the presentation manifestation of Neuro-Behçet. In 4 patients (12%) the presence of odynophagia secondary to the presence of oropharyngeal lesions, initially interpreted as acute or recurrent tonsillitis, was the first manifestation of the disease, alone or associated with cutaneous or ocular lesions.

CONCLUSIONS

In addition to the characteristic oral ulcers present in most patients with BD, ulcers in the oropharynx, occasionally interpreted as acute pharyngitis, are also common in these patients. Audiovestibular manifestations frequently appear during the course of the disease and may be the first symptom of central nervous system involvement.

摘要

引言与目的

白塞病(BD)是一种病因不明的系统性免疫介导性血管炎,其特征为复发性口生殖器溃疡、眼部炎症和皮肤病变。我们研究的目的是确定与白塞病相关的耳鼻喉(ENT)表现。

患者与方法

回顾性分析在22年期间于西班牙坎塔布里亚一家三级公立医院就诊的所有诊断为白塞病患者的病历。从病历中获取临床表现,尤其是与耳鼻喉相关的表现。对白塞病的耳鼻喉表现进行了医学文献综述。

结果

本研究纳入了33例患者(年龄范围:17 - 64岁)。他们中的大多数出现口腔溃疡(97%)。8例患者(24%)出现口咽溃疡,5例患者(15%)出现听前庭症状(高频感音神经性听力损失、眩晕和双侧前庭功能减退)。1例患者出现与前庭神经炎相符的症状,作为神经白塞病的首发表现。4例患者(12%)因口咽病变继发吞咽痛,最初被解释为急性或复发性扁桃体炎,是该病的首发表现,单独出现或伴有皮肤或眼部病变。

结论

除大多数白塞病患者存在的典型口腔溃疡外,口咽溃疡在这些患者中也很常见,偶尔被解释为急性咽炎。听前庭表现在疾病过程中经常出现,可能是中枢神经系统受累的首发症状。

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