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原发性干燥综合征中的普卢默-文森综合征:病例回顾

Plummer-Vinson syndrome in primary Sjögren syndrome: a case-based review.

作者信息

de Carvalho Jozélio Freire, Lerner Aaron

机构信息

Universidade Federal da Bahia, Rua das Violetas, 42, ap. 502, Pituba, Salvador, Bahia, Brazil.

Chaim Sheba Medical Center, The Zabludowicz Research Center for Autoimmune Diseases, Tel Hashomer, Israel.

出版信息

Immunol Res. 2022 Feb;70(1):19-22. doi: 10.1007/s12026-021-09243-y. Epub 2021 Oct 14.

Abstract

This study aimed to describe a patient with Sjögren syndrome who developed Plummer-Vinson syndrome, and to review the literature and describe shared aspects of this rare association. A systematic screening of articles was conducted in PubMed/MEDLINE, LILACS, SciELO, Scopus, Web of Science, and Cochrane, dating 1940 to 2020. All the articles included the association between Sjögren syndrome and Plummer-Vinson syndrome. No language restriction was applied. The following terms were used: "Sjögren syndrome" or "sicca syndrome" and "Plummer-Vinson syndrome" or "Paterson-Kelly syndrome." We performed our analysis by adding our present case, with a total of 4 cases. Three out of four were female (75%), age varied from 56 to 58 years old. In 2 cases, Sjögren syndrome preceded Plummer-Vinson syndrome diagnosis, and in 1 report, Plummer-Vinson syndrome appeared before Sjögren syndrome. Disease duration varied from 7 to 20 years. In two cases, autoantibodies were available, and antinuclear antibodies and anti-Ro/SS-A were positive in both, and anti-La/SS-B in one of them was associated with anti-dsDNA; however, no data regarding lupus was available in the article. Treatment involved iron supplementation in 3/3. Two out of three received parenteral iron supplementation, and in these two cases, mechanical esophageal dilatation was needless. In the other case, an additional endoscopic esophageal dilatation was necessary to receive the oral iron supplement. All 3 cases had a good outcome. This case illustrates a patient with Sjögren syndrome who developed the rare Plummer-Vinson syndrome. In Sjögren syndrome, the presence of iron-deficiency anemia, dysphagia, and weight loss should alert the physician to search for associated Plummer-Vinson syndrome.

摘要

本研究旨在描述一名患干燥综合征并发展为普卢默-文森综合征的患者,并回顾相关文献,阐述这种罕见关联的共同特征。在PubMed/MEDLINE、LILACS、SciELO、Scopus、Web of Science和Cochrane数据库中对1940年至2020年发表的文章进行了系统筛选。所有文章均涉及干燥综合征与普卢默-文森综合征的关联,且无语言限制。使用了以下检索词:“干燥综合征”或“口干燥症”以及“普卢默-文森综合征”或“帕特森-凯利综合征”。我们将本病例纳入分析,共4例。4例中有3例为女性(75%),年龄在56至58岁之间。2例中干燥综合征先于普卢默-文森综合征被诊断,1例报告中普卢默-文森综合征先于干燥综合征出现。病程从7年至20年不等。2例有自身抗体检测结果,抗核抗体和抗Ro/SS-A均为阳性,其中1例抗La/SS-B阳性且与抗双链DNA相关;然而,文章中未提供狼疮相关数据。3例患者均接受了补铁治疗。3例中有2例接受了胃肠外补铁,这2例无需进行机械性食管扩张。另1例则需要额外进行内镜下食管扩张以接受口服补铁。所有3例预后良好。本病例展示了一名患干燥综合征并发展为罕见的普卢默-文森综合征的患者。在干燥综合征患者中,若出现缺铁性贫血、吞咽困难和体重减轻,医生应警惕是否合并普卢默-文森综合征。

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