肉芽肿性多血管炎与诊断不足的脊柱关节炎罕见关联，利妥昔单抗有效治疗：一例报告
Rare association of granulomatosis with polyangiitis with an underdiagnosed spondyloarthritis effectively treated with rituximab: A case-report.
作者信息
Escoda Thomas, Dehaene Aurélie, Velardocchio Laetitia, Deveze Arnaud, Terrier Benjamin, Chiche Laurent
机构信息
Service de Médecine Interne, Hôpital Européen, Marseille, France.
Service de Radiologie, Hôpital Européen, Marseille, France.
出版信息
Medicine (Baltimore). 2025 Jan 31;104(5):e41366. doi: 10.1097/MD.0000000000041366.
RATIONALE
Associations of autoimmune diseases are rare but interesting and challenging situations from a diagnostic, pathophysiological, and therapeutic point of view. This article studies a rare association of autoimmune diseases by discussing the pathophysiological hypotheses and an original therapeutic management. The coexistence of antineutrophil cytoplasmic antibody-associated vasculitis and spondyloarthritis has rarely been described.
PATIENT CONCERNS
We present a patient with inflammatory back pain, stiffness, and enthesopathies followed by pulmonary and ear, nose and throat granulomatous involvement.
DIAGNOSES
A combination of spondyloarthritis and granulomatosis with polyangiitis, with spinal, enthesopathic, pulmonary, and ear, nose and throat involvement.
INTERVENTIONS AND OUTCOMES
Effective treatment with rituximab both on spondyloarthritis and vasculitis.
LESSONS
We discuss the pathogenic, diagnostic, and therapeutic implications of this rare but intriguing association between these 2 inflammatory conditions.
原理
自身免疫性疾病的关联罕见，但从诊断、病理生理和治疗角度来看，既有趣又具有挑战性。本文通过讨论病理生理假说和一种创新的治疗方法，研究了一种罕见的自身免疫性疾病关联。抗中性粒细胞胞浆抗体相关性血管炎和脊柱关节炎并存的情况鲜有报道。
患者情况
我们报告一例患者，最初表现为炎性背痛、僵硬和附着点病，随后出现肺部以及耳、鼻、喉肉芽肿性病变。
诊断
脊柱关节炎合并肉芽肿性多血管炎，累及脊柱、附着点、肺部以及耳、鼻、喉。
干预措施及结果
利妥昔单抗对脊柱关节炎和血管炎均有有效治疗作用。
经验教训
我们讨论了这两种炎症性疾病之间这种罕见但引人关注的关联在发病机制、诊断和治疗方面的意义。
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