狼疮性视网膜病变转变为菊池-藤本病。
Retinopathy in lupus transitioned to Kikuchi-Fujimoto disease.
作者信息
Rue Kelly S, Rodger Damien C, Rao Narsing A
机构信息
University of Southern California Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States.
出版信息
Am J Ophthalmol Case Rep. 2016 Jun 15;3:43-46. doi: 10.1016/j.ajoc.2016.06.004. eCollection 2016 Oct.
PURPOSE
We present a patient with systemic lupus erythematosus with significant vaso-occlusive retinal findings mimicking antiphospholipid antibody syndrome, who developed Kikuchi-Fujimoto disease.
OBSERVATIONS
Our patient was initially diagnosed with systemic lupus erythematosus with antiphospholipid antibody syndrome given consistent serologic markers and profound retinal vascular ischemia. However, on subsequent follow up, she presented with fever and lymphadenopathy and underwent lymph node biopsy, which declared histologic findings of Kikuchi-Fujimoto disease. Repeat markers for antiphospholipid antibody syndrome were negative and she was taken off lifelong anticoagulation.
CONCLUSIONS AND IMPORTANCE
Systemic lupus erythematosus and Kikuchi-Fujimoto disease may have many similar features and even biomarkers, and given the potential overlap of presentation, clinicians must carefully distinguish between these diseases to prevent unnecessary treatment.
目的
我们报告一名系统性红斑狼疮患者，其具有显著的血管闭塞性视网膜表现，类似于抗磷脂抗体综合征，该患者后来发展为菊池-藤本病。
观察结果
我们的患者最初因血清学指标一致且存在严重的视网膜血管缺血而被诊断为系统性红斑狼疮合并抗磷脂抗体综合征。然而，在随后的随访中，她出现发热和淋巴结病，并接受了淋巴结活检，活检结果显示为菊池-藤本病的组织学表现。抗磷脂抗体综合征的重复检测指标为阴性，她也停用了终身抗凝治疗。
结论及重要性
系统性红斑狼疮和菊池-藤本病可能有许多相似特征甚至生物标志物，鉴于临床表现可能存在重叠，临床医生必须仔细区分这两种疾病，以避免不必要的治疗。
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