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困境:混合性结缔组织病患者的硬皮病肾危象与狼疮性肾炎

The dilemma: scleroderma renal crisis vs lupus nephritis in a patient with mixed connective tissue disorder.

作者信息

Jackson Nicola, Betty Shion, Appiah-Pippim James, Bueno Yolin, Makhdumi Sana

机构信息

Department of Internal Medicine, Piedmont Athens Regional Hospital, Athens, Georgia, USA.

出版信息

J Community Hosp Intern Med Perspect. 2021 Nov 15;11(6):852-855. doi: 10.1080/20009666.2021.1983320. eCollection 2021.

Abstract

INTRODUCTION

Mixed connective tissue disorder (MCTD) is a rare connective tissue disorder characterized by features of systemic lupus erythematosus, dermatomyositis, systemic sclerosis, and rheumatoid arthritis. MCTD is associated with an elevated antibody titer to U1 small nuclear ribonucleoprotein.

CASE DESCRIPTION

A 49-year-old man presented to the emergency department for evaluation of worsening shortness of breath with associated for bilateral hand pain and swelling associated with morning stiffness which was initially thought to be related to systemic lupus erythematous (SLE). He was also found to have a positive autoantibody, and he was later diagnosed with MCTD complicated by scleroderma renal crisis.

CONCLUSION

MCTD is a rare connective tissue disorder with overlapping features of SLE, dermatomyositis, systemic sclerosis, and rheumatoid arthritis. The diagnosis of MCTD requires a high index of suspicion and careful workup. Immunosuppressive therapy is the mainstay of treatment that improves patient outcomes.

摘要

引言

混合性结缔组织病(MCTD)是一种罕见的结缔组织病,其特征为具有系统性红斑狼疮、皮肌炎、系统性硬化症和类风湿关节炎的特点。MCTD与抗U1小核糖核蛋白抗体滴度升高有关。

病例描述

一名49岁男性因气促加重到急诊科就诊,伴有双手疼痛和肿胀,并伴有晨僵,最初认为与系统性红斑狼疮(SLE)有关。还发现他自身抗体呈阳性,后来被诊断为MCTD并伴有硬皮病肾危象。

结论

MCTD是一种罕见的结缔组织病,具有SLE、皮肌炎、系统性硬化症和类风湿关节炎的重叠特征。MCTD的诊断需要高度怀疑并进行仔细检查。免疫抑制治疗是改善患者预后的主要治疗方法。

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