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模仿巨细胞动脉炎的钙化防御：一例报告

Calciphylaxis Mimicking Giant Cell Arteritis: A Case Report.

作者信息

Alyousef Nada, Alsakran Wael A, Maktabi Azza

机构信息

Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.

Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.

出版信息

Case Rep Ophthalmol. 2024 Oct 4;15(1):717-723. doi: 10.1159/000541410. eCollection 2024 Jan-Dec.

DOI:10.1159/000541410
PMID:39474013
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11521537/
Abstract

INTRODUCTION

Calciphylaxis is a condition that causes vascular calcification and intimal proliferation with thrombotic occlusion of small-to-medium-sized vessels.

CASE PRESENTATION

We describe a case of a 64-year-old woman who presented with a clinical picture that was suggestive of anterior arteritic ischemic optic neuropathy due to giant cell arteritis (GCA), but was found to have calciphylaxis confirmed by histologic examination. When calciphylaxis affects the blood supply to the eye, commonly it causes sudden vision loss, pallid optic disk edema, and a relative afferent pupillary defect, all of which were observed in our patient.

CONCLUSION

There is no known cure for calciphylaxis, while in GCA, high-dose corticosteroid therapy is essential to prevent involvement of the contralateral eye. As the management approaches for these two diseases are different, it is important to have performed a thorough clinical examination along with detailed histopathological testing to rule out calciphylaxis of the temporal artery in patients suspected to have GCA.

摘要

引言

钙化防御是一种导致血管钙化和内膜增生，并伴有中小血管血栓性闭塞的病症。

病例介绍

我们描述了一例64岁女性患者，其临床表现提示因巨细胞动脉炎（GCA）导致的前部动脉炎性缺血性视神经病变，但经组织学检查确诊为钙化防御。当钙化防御影响眼部血液供应时，通常会导致突然视力丧失、苍白性视盘水肿和相对性传入瞳孔障碍，所有这些在我们的患者中均有观察到。

结论

钙化防御尚无已知的治愈方法，而在GCA中，高剂量皮质类固醇治疗对于预防对侧眼受累至关重要。由于这两种疾病的治疗方法不同，对于疑似患有GCA的患者，进行全面的临床检查以及详细的组织病理学检测以排除颞动脉钙化防御非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4531/11521537/7707c87fcb29/cop-2024-0015-0001-541410_F04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4531/11521537/e8a4915540bc/cop-2024-0015-0001-541410_F01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4531/11521537/1bc5d13ebb92/cop-2024-0015-0001-541410_F02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4531/11521537/8b18de7e2906/cop-2024-0015-0001-541410_F03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4531/11521537/7707c87fcb29/cop-2024-0015-0001-541410_F04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4531/11521537/e8a4915540bc/cop-2024-0015-0001-541410_F01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4531/11521537/1bc5d13ebb92/cop-2024-0015-0001-541410_F02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4531/11521537/8b18de7e2906/cop-2024-0015-0001-541410_F03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4531/11521537/7707c87fcb29/cop-2024-0015-0001-541410_F04.jpg

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本文引用的文献

1
Calciphylaxis a Giant Cell Arteritis Mimic: A Case Report and Review of the Literature.
J Neuroophthalmol. 2022 Mar 1;42(1):e362-e366. doi: 10.1097/WNO.0000000000001395. Epub 2021 Aug 18.
2
An unusual case of calciphylaxis in a psoriatic patient without kidney disease.一名无肾脏疾病的银屑病患者发生钙过敏的罕见病例。
JAAD Case Rep. 2021 Feb 2;10:41-43. doi: 10.1016/j.jdcr.2021.01.024. eCollection 2021 Apr.
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Demographics, Comorbid Conditions, and Outcomes of Patients With Nonuremic Calciphylaxis.非尿毒症性钙化防御患者的人口统计学、合并症和结局。
JAMA Dermatol. 2019 Feb 1;155(2):251-252. doi: 10.1001/jamadermatol.2018.4937.
4
Calciphylaxis after parathyroidectomy.甲状旁腺切除术后的钙化防御。
Hemodial Int. 2017 Oct;21 Suppl 2:S62-S66. doi: 10.1111/hdi.12599.
5
Calciphylaxis: risk factors, diagnosis, and treatment.钙过敏症：危险因素、诊断与治疗
Am J Kidney Dis. 2015 Jul;66(1):133-46. doi: 10.1053/j.ajkd.2015.01.034. Epub 2015 May 7.
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Calcific uraemic arteriolopathy in a patient with end-stage renal failure and chronic plaque psoriasis: could TNF-α inhibition help ameliorate disease progression?一名终末期肾衰竭合并慢性斑块状银屑病患者的钙化性尿毒症小动脉病：肿瘤坏死因子-α抑制能否有助于改善疾病进展？
Australas J Dermatol. 2015 Feb;56(1):68-9. doi: 10.1111/ajd.12225.
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Risk factors and mortality associated with calciphylaxis in end-stage renal disease.终末期肾病中与钙化防御相关的危险因素及死亡率
Kidney Int. 2001 Jul;60(1):324-32. doi: 10.1046/j.1523-1755.2001.00803.x.
8
Calciphylaxis in a hemodialysis patient: appearance after parathyroidectomy during a psoriatic flare.一名血液透析患者的钙化防御：银屑病发作期间甲状旁腺切除术后的表现。
Am J Kidney Dis. 1992 Mar;19(3):285-8. doi: 10.1016/s0272-6386(13)80011-x.