Jeleniewicz Radosław, Suszek Dorota, Majdan Maria
Klinika Reumatologii i Układowych Chorób Tkanki Łącznej, Uniwersytet Medyczny w Lublinie, Lublin, Polska.
Wiad Lek. 2018;71(1 pt 1):17-20.
Introduction: Musculoskeletal symptoms are not characteristic for granulomatosis with polyangiitis (GPA) patients. However, they could be present in two-thirds of patients at the onset of the disease and may provoke diagnostic difficulties. The aim: To assess retrospectively musculoskeletal manifestations in a group of GPA patients.
Material and methods: The analyzed group consisted of 44 patients with GPA (27M, 17F) aged 46.7 years (16-75) and treated at the Department of Rheumatology and Connective Tissue Diseases in Lublin between 2010-2016. All patients were c-ANCA positive, and p-ANCA were present only in one patient (2.3%). The delay in GPA diagnosis averaged 15.9 months (0-166).
Results: Joint manifestations were present in 43.2 % of patients (non-destructive arthritis in 22.7%, arthralgia in 20.5%), in 73.7% of cases anticipating GPA diagnosis by on average of 20.1 months (4-98). In 57.5% of patients joint manifestations were present from the beginning of the disease, most commonly as polyarthritis (68.4%). Myalgia was reported by 11.4% of patients. Among patients with arthritis 5 were RF-positive, none ACPA-positive, and 1 had ANA present.
Conclusions: Musculoskeletal manifestations appear in a high proportion of GPA patients, in most cases preceding the diagnosis. Such a situation may cause diagnostic difficulties and the diagnosis delay.
引言：肌肉骨骼症状并非肉芽肿性多血管炎（GPA）患者的特征性表现。然而，在疾病发作时，三分之二的患者可能出现此类症状，这可能会引发诊断困难。目的：回顾性评估一组GPA患者的肌肉骨骼表现。
材料与方法：分析组由44例GPA患者组成（27例男性，17例女性），年龄46.7岁（16 - 75岁），于2010 - 2016年在卢布林的风湿病与结缔组织病科接受治疗。所有患者c-ANCA均为阳性，仅1例患者（2.3%）p-ANCA阳性。GPA诊断延迟平均为15.9个月（0 - 166个月）。
结果：43.2%的患者出现关节表现（22.7%为非破坏性关节炎，20.5%为关节痛），73.7%的病例在GPA诊断前平均20.1个月（4 - 98个月）出现。57.5%的患者从疾病开始就出现关节表现，最常见的是多关节炎（68.4%）。11.4%的患者报告有肌痛。在有关节炎的患者中，5例RF阳性，无ACPA阳性，1例ANA阳性。
结论：大多数GPA患者在诊断前出现肌肉骨骼表现，且比例较高。这种情况可能导致诊断困难和诊断延迟。
