Otsuka Yukimi, Inoue Yasushi
Division of Rheumatology, Fukuoka Red Cross Hospital, Japan.
Intern Med. 2016;55(20):3043-3046. doi: 10.2169/internalmedicine.55.6849. Epub 2016 Oct 15.
Acute acalculous cholecystitis (AAC) is a severe disease seen in critically ill patients, including those with autoimmune diseases. We herein report the case of a 41-year-old female who developed macrophage activation syndrome (MAS) accompanied by a recurrence of Kikuchi disease. Abdominal imaging revealed marked thickening of the gallbladder wall and pericholecystic fluid, typically found in AAC. Treatment with intravenous pulse methylprednisolone induced in a significant improvement in the gallbladder wall, resulting in no need for surgical intervention. We should consider that patients with MAS may therefore sometimes develop AAC and that early immunosuppressive therapy can be effective in AAC cases associated with rheumatic or autoimmune diseases.
急性非结石性胆囊炎（AAC）是一种在重症患者中出现的严重疾病，包括患有自身免疫性疾病的患者。我们在此报告一例41岁女性患者，其出现巨噬细胞活化综合征（MAS）并伴有菊池病复发。腹部影像学检查显示胆囊壁明显增厚及胆囊周围积液，这是AAC的典型表现。静脉注射甲泼尼龙冲击治疗使胆囊壁有显著改善，从而无需手术干预。因此，我们应考虑到MAS患者有时可能会发生AAC，且早期免疫抑制治疗对与风湿性或自身免疫性疾病相关的AAC病例可能有效。
