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皮质类固醇联合硫唑嘌呤成功治疗系统性红斑狼疮相关的急性非结石性胆囊炎

Systemic Lupus Erythematosus-associated Acute Acalculous Cholecystitis Successfully Treated by a Corticosteroid Combined with Azathioprine.

作者信息

Kudo Noritaka, Takaoka Hirokazu, Shimomura Taizo, Suzushima Hitoshi, Fujiyama Shigetoshi

机构信息

Comprehensive Clinical Education, Training and Development Center, Kumamoto University Hospital, Japan.

Section of Internal Medicine and Rheumatology, Kumamoto Shinto General Hospital, Japan.

出版信息

Intern Med. 2019 Oct 1;58(19):2879-2885. doi: 10.2169/internalmedicine.2820-19. Epub 2019 Jun 27.

Abstract

A 69-year-old Japanese woman was transferred to our hospital due to pancytopenia with a fever. She had Murphy's sign, and computed tomography showed pleural effusion and a swollen gallbladder without gallstones. We diagnosed her with systemic lupus erythematosus (SLE)-associated acute acalculous cholecystitis (AAC). Partly because her clinical and laboratory findings were not serious enough to warrant immediate surgical intervention, and partly because her poor general condition made her ineligible for surgery, surgical therapy was not selected. Corticosteroid therapy was performed with azathioprine, and the swelling in her gallbladder improved. As a conservative therapy for SLE-associated AAC, corticosteroid therapy combined with azathioprine might be beneficial.

摘要

一名69岁的日本女性因全血细胞减少伴发热被转至我院。她有墨菲氏征,计算机断层扫描显示有胸腔积液和胆囊肿大但无胆结石。我们诊断她为系统性红斑狼疮(SLE)相关的急性非结石性胆囊炎(AAC)。部分原因是她的临床和实验室检查结果不够严重,不值得立即进行手术干预,部分原因是她的全身状况较差,不适合手术,因此未选择手术治疗。采用硫唑嘌呤进行皮质类固醇治疗,她胆囊的肿胀情况有所改善。作为SLE相关AAC的保守治疗方法,皮质类固醇治疗联合硫唑嘌呤可能有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c269/6815888/b0bc298eb2e7/1349-7235-58-2879-g001.jpg

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