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冷球蛋白血症并发肺炎

Cryoglobulinemia Complicated by Pneumonia.

作者信息

Kiguradze Luka, Onoprishvili Elizabeth, Shvelidze Khatuna, Vacharadze Kakha

机构信息

Internal Medicine, David Tvildiani Medical University, Tbilisi, GEO.

Internal Medicine, Israeli-Georgian Multiprofile Medical Center "Healthycore", Tbilisi, GEO.

出版信息

Cureus. 2024 Dec 10;16(12):e75466. doi: 10.7759/cureus.75466. eCollection 2024 Dec.

DOI:10.7759/cureus.75466
PMID:39791023
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11717061/
Abstract

This study describes a 64-year-old female with a history of hepatitis C and cryoglobulinemia, who presented with respiratory symptoms, including dry cough, shortness of breath, and fever, alongside joint pain and fatigue. Initial workup revealed interstitial pneumonia, supported by chest imaging, and the patient was treated for pneumonia with standard antibiotic therapy. Despite no renal involvement, a hallmark of cryoglobulinemia, further testing confirmed elevated serum cryoglobulin levels. The patient was diagnosed with cryoglobulinemia complicated by pneumonia, a rare but significant manifestation of this disorder. Treatment was initiated with corticosteroids and immunosuppressive therapy. Cryoglobulinemia typically presents with renal complications, such as membranoproliferative glomerulonephritis, but this case highlights an atypical involvement of pulmonary pathology and arthritis without renal dysfunction. The patient responded well to therapy and was discharged with outpatient follow-up. This report underscores the importance of considering cryoglobulinemia in the differential diagnosis of patients with vasculitis symptoms, even when renal manifestations are absent. Additionally, it highlights the limited documentation of the association between cryoglobulinemia and pulmonary complications. Noting this association is crucial so that a clearer pattern can be established if more cases arise.

摘要

本研究描述了一名64岁女性,有丙型肝炎和冷球蛋白血症病史,出现呼吸道症状,包括干咳、气短和发热,同时伴有关节疼痛和疲劳。初步检查发现间质性肺炎,胸部影像学检查支持这一诊断,患者接受了标准抗生素治疗肺炎。尽管没有肾脏受累,这是冷球蛋白血症的一个特征,但进一步检查证实血清冷球蛋白水平升高。该患者被诊断为冷球蛋白血症合并肺炎,这是该疾病一种罕见但重要的表现形式。开始使用皮质类固醇和免疫抑制疗法进行治疗。冷球蛋白血症通常表现为肾脏并发症,如膜增生性肾小球肾炎,但该病例突出了肺部病理和关节炎的非典型受累且无肾功能障碍。患者对治疗反应良好,出院后进行门诊随访。本报告强调了在血管炎症状患者的鉴别诊断中考虑冷球蛋白血症的重要性,即使没有肾脏表现。此外,它突出了冷球蛋白血症与肺部并发症之间关联的文献记载有限。注意到这种关联至关重要,以便如果出现更多病例时能够建立更清晰的模式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/769f/11717061/afc65b6273bc/cureus-0016-00000075466-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/769f/11717061/afc65b6273bc/cureus-0016-00000075466-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/769f/11717061/afc65b6273bc/cureus-0016-00000075466-i01.jpg

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[Renal involvement of cryoglobulinemia].[冷球蛋白血症的肾脏受累]
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本文引用的文献

1
Essential Mixed Cryoglobulinemic Vasculitis: Sole Onset with Acute Respiratory Distress Syndrome.原发性混合性冷球蛋白血症性血管炎:以急性呼吸窘迫综合征为唯一首发表现
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New insights in cryoglobulinemic vasculitis.
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Cryoglobulinemia (review).冷球蛋白血症(综述)。
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Mixed cryoglobulinemia.混合性冷球蛋白血症
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Mixed cryoglobulinemia: demographic, clinical, and serologic features and survival in 231 patients.混合性冷球蛋白血症:231例患者的人口统计学、临床和血清学特征及生存情况
Semin Arthritis Rheum. 2004 Jun;33(6):355-74. doi: 10.1016/j.semarthrit.2003.10.001.
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Cryoglobulinemia: study of etiologic factors and clinical and immunologic features in 443 patients from a single center.冷球蛋白血症:来自单一中心的443例患者的病因学因素、临床及免疫学特征研究
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