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类风湿关节炎中的肝脏化学指标异常与腿部水肿

Liver chemistry abnormalities and leg oedema in rheumatoid arthritis.

作者信息

van Soest Eva Marianne, Liem Anho, van Zeben Jende

机构信息

Rheumatology, Erasmus MC, Rotterdam, The Netherlands.

Rheumatology, Sint Franciscus Vlietland Groep, Rotterdam, The Netherlands.

出版信息

BMJ Case Rep. 2018 Apr 19;2018:bcr-2017-223206. doi: 10.1136/bcr-2017-223206.

DOI:10.1136/bcr-2017-223206
PMID:29674399
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5911143/
Abstract

A 66-year-old man with seronegative, erosive rheumatoid arthritis for 12 years presented with malaise, elevated alkaline phosphatase and gamma-glutamyl transferase, and leg oedema. He subsequently developed ascites. No liver pathology was found, but cardiac analysis including right heart catheterisation revealed constrictive pericarditis. Rheumatoid constrictive pericarditis is a rare condition, but, despite current effective treatment for rheumatoid arthritis, still occurs. Diagnostic delay is frequent. Although mortality of the intervention is high, pericardiectomy is needed for most patients.

摘要

一名66岁男性，患血清阴性侵蚀性类风湿关节炎12年，出现全身不适、碱性磷酸酶和γ-谷氨酰转移酶升高以及腿部水肿。随后出现腹水。未发现肝脏病变，但包括右心导管检查在内的心脏检查显示为缩窄性心包炎。类风湿性缩窄性心包炎是一种罕见疾病，尽管目前对类风湿关节炎有有效的治疗方法，但仍会发生。诊断延误很常见。虽然手术死亡率很高，但大多数患者仍需要进行心包切除术。

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本文引用的文献

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Interact Cardiovasc Thorac Surg. 2012 Apr;14(4):479-80. doi: 10.1093/icvts/ivr135. Epub 2012 Jan 9.
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