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[一位年轻女性患者的肌炎中的肌肉疼痛:这背后是什么?]

[Muscle pain in myositis in a young female patient: what is behind this?].

作者信息

Doblinger N, Doenz J, Tews H C, Demirci C, Schmid S, Michels B, Müller M, Kandulski A

机构信息

Klinik und Poliklinik für Innere Medizin 1, Gastroenterologie, Hepatologie, Endokrinologie, Rheumatologie und Infektiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.

Abteilung für Innere Medizin, Gastroenterologie, St. Theresien-Krankenhaus Nürnberg gGmbH, Nürnberg, Deutschland.

出版信息

Inn Med (Heidelb). 2024 Nov;65(11):1150-1153. doi: 10.1007/s00108-024-01761-9. Epub 2024 Aug 9.

Abstract

Myositis is a connective tissue disease which is most frequently diagnosed in women aged 40-60 years. Due to a clear association with underlying malignant diseases, general tumor screening is recommended whenever it is diagnosed. Colorectal carcinoma (CRC) is a common malignant disease, and the typical at-risk group comprised, to date, patients older than 55 years. However, with the rising incidence of so-called early-onset colorectal carcinoma (EO-CRC), an increasingly important patient population is emerging in the 20- to 50-year age range. One reason for the rising incidence is suggested to be an increase in classic risk factors at younger ages. Here, the case of a 34-year-old female patient who presented with the leading paraneoplastic syndrome of myositis and was diagnosed with a sporadic form of CRC is reported. Monitoring of known risk factors as early on as in young adulthood and greater attention in the presence of symptoms such as gastrointestinal hemorrhage or paraneoplastic syndromes seem necessary to compensate for the time delay in diagnosis that currently still exists and the associated worse oncologic outcome.

摘要

肌炎是一种结缔组织病,最常发生于40至60岁的女性。由于其与潜在恶性疾病存在明确关联,一旦确诊,建议进行全面的肿瘤筛查。结直肠癌(CRC)是一种常见的恶性疾病,迄今为止,典型的高危人群为55岁以上的患者。然而,随着所谓早发性结直肠癌(EO-CRC)发病率的上升,20至50岁年龄段中出现了越来越多的重要患者群体。发病率上升的一个原因被认为是年轻时经典风险因素的增加。在此,报告了一名34岁女性患者的病例,该患者表现出肌炎的主要副肿瘤综合征,并被诊断为散发性结直肠癌。早在青年期就对已知风险因素进行监测,以及在出现胃肠道出血或副肿瘤综合征等症状时给予更多关注,对于弥补目前仍然存在的诊断时间延迟以及相关的更差肿瘤学结局似乎是必要的。

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