Li Yan-Jun, Li Shu-Jie, Li Dong-Mei, Yan Hong-Xia, Shi Dong-Mei
School of Clinical Medicine, Weifang Medical University, Weifang, CHN.
Department of Rheumatology and Immunology, Jining No. 1 People's Hospital, Jining, CHN.
Cureus. 2024 Jan 9;16(1):e51986. doi: 10.7759/cureus.51986. eCollection 2024 Jan.
A 66-year-old neurofibromatosis type 1 (NF1) patient with polyarticular pain for nine years, aggravated for two days, was transferred from the Emergency Intensive Care Unit (EICU) to our rheumatology department. She was diagnosed with NF1 nine years ago by a gene mutation detection and coronary heart disease (CHD) three months ago. The patient was diagnosed with rheumatoid arthritis (RA) this time. After 24 days of treatment with appropriate medication, the patient was discharged with relieved joint pain. However, about four months later, the patient died of circulatory failure caused by myocardial infarction. We analyzed the possible reasons for her outcome and made a review of the literature. There are few clinical reports of NF1 complicated with RA. We found five cases reported in the literature up to date during our search and included them in our communication to compare with our case. NF1 combined with RA mainly affects adult women and usually starts with NF1 and is followed by RA after at least six years of NF1 symptom onset. Although the summarized characteristics of clinical and potential pathogenesis of NF1 combined with RA were limited with these six cases, we hope that this will help clinicians to increase their understanding of this rare complication, thus helping to guide clinical medication.
一名66岁的1型神经纤维瘤病(NF1)患者,多关节疼痛九年,加重两天,从急诊重症监护病房(EICU)转入我院风湿科。九年前她通过基因突变检测被诊断为NF1,三个月前被诊断为冠心病(CHD)。此次患者被诊断为类风湿关节炎(RA)。经过24天的适当药物治疗,患者关节疼痛缓解后出院。然而,大约四个月后,患者死于心肌梗死引起的循环衰竭。我们分析了她出现这种结局的可能原因并进行了文献复习。NF1合并RA的临床报道很少。我们在检索过程中发现截至目前文献报道了五例,并将它们纳入我们的交流内容中与我们的病例进行比较。NF1合并RA主要影响成年女性,通常以NF1起病,在NF1症状出现至少六年之后继发RA。尽管这六例病例对NF1合并RA的临床和潜在发病机制的总结特征有限,但我们希望这将有助于临床医生增加对这种罕见并发症的认识,从而有助于指导临床用药。