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分析 13 例 Weber-Christian 脂膜炎患者的临床特征。

Analysis of the clinical characteristics of thirteen patients with Weber-Christian panniculitis.

机构信息

Graduate school of Soochow University, Soochow University, Suzhou, China.

Department of Infectious Diseases, Linan People's Hospital, Hangzhou, China.

出版信息

Clin Rheumatol. 2019 Dec;38(12):3635-3641. doi: 10.1007/s10067-019-04722-y. Epub 2019 Aug 12.

Abstract

BACKGROUND

Weber-Christian disease (WCD) is an uncommon, idiopathic disease that is challenging to diagnose and has an unclear treatment protocol. We reviewed thirteen patients with WCD and analyzed their clinical characteristics. The purpose of this article was to improve the understanding of this rare disorder.

METHODS

Thirteen cases of WCD were analyzed retrospectively regarding their clinical manifestation, laboratory results, misdiagnoses, therapy, and outcome.

RESULTS

Of the thirteen patients diagnosed with WCD, the majority were female (male to female ratio, 2:11), with a mean patient age of 50.1 years. Subcutaneous nodules were the most commonly reported symptom, followed by fever, arthralgias/arthritis, and myalgia. The laboratory results were typically nonspecific. In total, 61.5% patients were misdiagnosed before pathology confirmed the diagnosis of WCD. Most patients were treated with corticosteroids and/or immunosuppressants. Two patients were treated surgically. While long-term remission was successfully achieved in some patients, others had recurrent symptoms.

CONCLUSION

WCD was predominantly observed in female patients in our cohort. Subcutaneous nodules and fever were the most common clinical characteristics. In addition, the patients' laboratory test results were nonspecific, which led to a high misdiagnosis rate. In this study population, corticosteroid and/or immunosuppressant treatments were efficacious therapeutic interventions for WCD.Key Points•Subcutaneous nodules and fever were the most common clinical characteristics in Weber-Christian panniculitis.•Misdiagnosis rate was higher in Weber-Christian panniculitis patient; tumors, bacterial infections and rheumatic diseases were the most common misdiagnoses.•Corticosteroid and/or immunosuppressant therapy was effective in most Weber-Christian panniculitis patients.

摘要

背景

韦氏-克里斯蒂安病(WCD)是一种罕见的特发性疾病,诊断具有挑战性,且治疗方案尚不明确。我们回顾了 13 例 WCD 患者,并分析了他们的临床特征。本文旨在提高对这种罕见疾病的认识。

方法

回顾性分析了 13 例 WCD 患者的临床表现、实验室结果、误诊、治疗和结局。

结果

在诊断为 WCD 的 13 例患者中,大多数为女性(男女比为 2:11),平均年龄为 50.1 岁。皮下结节是最常见的症状,其次是发热、关节痛/关节炎和肌痛。实验室结果通常是非特异性的。总共 61.5%的患者在病理证实 WCD 诊断之前被误诊。大多数患者接受了皮质类固醇和/或免疫抑制剂治疗。2 例患者接受了手术治疗。虽然一些患者长期缓解成功,但其他患者出现了症状复发。

结论

在我们的队列中,WCD 主要发生在女性患者中。皮下结节和发热是最常见的临床特征。此外,患者的实验室检查结果不具有特异性,导致误诊率较高。在本研究人群中,皮质类固醇和/或免疫抑制剂治疗是 WCD 的有效治疗干预措施。

关键点

  1. 皮下结节和发热是韦氏-克里斯蒂安脂膜炎最常见的临床特征。

  2. 韦氏-克里斯蒂安脂膜炎患者误诊率较高;肿瘤、细菌感染和风湿性疾病是最常见的误诊。

  3. 皮质类固醇和/或免疫抑制剂治疗对大多数韦氏-克里斯蒂安脂膜炎患者有效。

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