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年轻女性以视网膜中央动脉阻塞为首发表现的混合性结缔组织病 1 例报告

Central retinal artery occlusion as the initial manifestation of mixed connective tissue disease in a young woman: a case report.

机构信息

Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Department of Rheumatology and Immunology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

出版信息

BMC Ophthalmol. 2024 Oct 16;24(1):454. doi: 10.1186/s12886-024-03713-1.

Abstract

BACKGROUND

Retinal artery occlusions are rare amongst young adults, and relevant risk factors and etiology remain unclear. In this report, we present a case of central retinal artery occlusion (CRAO) as the initial manifestation of mixed connective tissue disease (MCTD) in a young woman.

CASE PRESENTATION

A 22-year-old female presented to the emergency department with a sudden decrease in visual acuity in her right eye for 1 hour. She reported a similar episode in her left eye five years prior, which resolved spontaneously after 2 hours. Initially misdiagnosed with optic neuritis in the right eye at another hospital, she was referred to our institution the following day. Clinical examination revealed a CRAO in her right eye. A detailed medical history revealed that she had developed livedo reticularis (LR) on both lower limbs five years ago, which had been overlooked and untreated. Further rheumatologic history, hematologic tests, and an autoimmune work-up confirmed a diagnosis of mixed connective tissue disease (MCTD).

CONCLUSION

In young patients presenting with CRAO, further examinations should be conducted to investigate systemic disease or an embolic source to prevent future sequelae.

摘要

背景

视网膜动脉阻塞在年轻成年人中较为罕见,相关的风险因素和病因仍不清楚。在本报告中,我们介绍了一例以中央性视网膜动脉阻塞(CRAO)为首发表现的混合性结缔组织病(MCTD)年轻女性病例。

病例介绍

一名 22 岁女性因右眼视力突然下降 1 小时就诊于急诊科。她报告称五年前左眼曾出现类似症状,2 小时后自行缓解。最初在另一家医院被误诊为右眼视神经炎,次日转至我院。临床检查发现右眼 CRAO。详细的病史显示,五年前她的双下肢出现网状青斑(LR),但被忽视且未予治疗。进一步的风湿病史、血液学检查和自身免疫检查证实了混合性结缔组织病(MCTD)的诊断。

结论

对于出现 CRAO 的年轻患者,应进行进一步检查以调查全身性疾病或栓塞源,以预防未来的后遗症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63dd/11481478/a33f313f24bd/12886_2024_3713_Fig1_HTML.jpg

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