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埃文斯综合征合并类风湿关节炎和系统性红斑狼疮:自身免疫交叉的一个独特病例。

Evans syndrome in conjunction with rheumatoid arthritis and SLE: A unique case of autoimmune intersection.

作者信息

Hashim Hashim Talib, Al-Obaidi Ahmed Dheyaa, Al-Fatlawi Nabeel, Hassan Karrar Hussein, Al-Asadi Azhar Kareem, Al-Rihaymee Afrah Majeed Ahmed, Al-Obiade Reem, Joffrey Meelad, Al-Badri Sajjad Ghanim, Al-Awad Abdullah

机构信息

Research Department, University of Warith Al-Anbiyaa, College of Medicine, Karbala, Iraq.

Deparment of Internal Medicine, University of Baghdad, College of Medicine, Baghdad, Iraq.

出版信息

Radiol Case Rep. 2024 Sep 25;19(12):6323-6327. doi: 10.1016/j.radcr.2024.09.053. eCollection 2024 Dec.

Abstract

Evans syndrome is a rare autoimmune disorder characterized by autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP), often linked with systemic lupus erythematosus (SLE). We present a case of a 25-year-old female with a history of rheumatoid arthritis (RA) who presented with new SLE symptoms, including left-sided weakness, pallor, and a photosensitive rash. Laboratory tests confirmed Evans syndrome, and MRI showed a cerebral infarction. Treatment with corticosteroids, hydroxychloroquine, and mycophenolate mofetil led to significant improvement. This case highlights the complexity of managing Evans syndrome in patients with coexisting autoimmune diseases like RA and SLE, emphasizing the need for early and aggressive treatment.

摘要

伊文氏综合征是一种罕见的自身免疫性疾病,其特征为自身免疫性溶血性贫血(AIHA)和免疫性血小板减少症(ITP),常与系统性红斑狼疮(SLE)相关。我们报告一例25岁女性,有类风湿关节炎(RA)病史,出现了新的SLE症状,包括左侧肢体无力、面色苍白和光敏性皮疹。实验室检查确诊为伊文氏综合征,MRI显示有脑梗死。使用皮质类固醇、羟氯喹和霉酚酸酯进行治疗后有显著改善。该病例凸显了在患有RA和SLE等共存自身免疫性疾病的患者中管理伊文氏综合征的复杂性,强调了早期积极治疗的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db30/11461976/1a47e90e12f6/gr1.jpg

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