Zhi Cherie S, Kesselhaut Julia R, Venuturupalli Swamy R, Ben-Artzi Ami
Rheumatology, Cedars-Sinai Medical Center, Los Angeles, USA.
Cureus. 2024 Feb 7;16(2):e53805. doi: 10.7759/cureus.53805. eCollection 2024 Feb.
We report a case of a 74-year-old male who presented with typical clinical features of rheumatoid arthritis (RA), as well as elevated markers of inflammation. However, the patient did not respond to multiple RA treatments, and an ultrasound-guided synovial biopsy (UGSB) of the right wrist was performed, which established the diagnosis of amyloidosis. A variety of inflammatory conditions sometimes get misdiagnosed as seronegative RA due to similarities in clinical presentation. This case report highlights the importance of a thorough workup in patients who appear to have seronegative RA. Given the wide availability of ultrasound-guided, minimally invasive synovial biopsies, these procedures should be employed more often to detect rare conditions that may mimic seronegative RA, such as amyloidosis.
我们报告了一例74岁男性患者，其表现出类风湿关节炎（RA）的典型临床特征以及炎症指标升高。然而，该患者对多种RA治疗均无反应，遂对其右手腕进行了超声引导下的滑膜活检（UGSB），确诊为淀粉样变性。由于临床表现相似，多种炎症性疾病有时会被误诊为血清阴性RA。本病例报告强调了对疑似血清阴性RA患者进行全面检查的重要性。鉴于超声引导下的微创滑膜活检广泛可用，应更频繁地采用这些检查方法来检测可能模拟血清阴性RA的罕见疾病，如淀粉样变性。
