Ma Jinlu, Cai Yunping, Shao Han, Dou Jingjing, Yang Yusheng, Fan Xiaoli, Lu Cui
Department of Rheumatology and Immunology, Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Zhongshan Middle Road No. 748, Songjiang District, Shanghai, 201600, China.
Department of Chinese Traditional Medicine, Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Zhongshan Middle Road No. 748, Songjiang District, Shanghai, 201600, China.
J Med Case Rep. 2025 Jul 29;19(1):373. doi: 10.1186/s13256-025-05440-7.
Eosinophilic fasciitis is an infrequent connective tissue disorder that often delays treatment owing to misdiagnosis or omission. In advanced stages, severe skin sclerosis can lead to joint contracture and tendon retraction, which can severely affect the quality of life. Therefore, it is important to make a clear diagnosis and intervene in the early stages of the disease.
We report a case of a 52-year-old Chinese patient with marked symmetric swelling of her extremities, especially forearms and calves, sclerosis of the subcutaneous tissue, limited joint mobility, and whose serologic markers showed markedly elevated serum eosinophils at the beginning of the consultation. The diagnosis of eosinophilic fasciitis was further clarified and treated after refinement of soft tissue magnetic resonance imaging and subcutaneous tissue biopsy, and the patient responded favorably to treatment with marked improvement in cutaneous sclerosis and the quality of life.
Enhanced magnetic resonance imaging and whole-layer biopsy plays a critical role in enabling early diagnosis of eosinophilic fasciitis, while early treatment with a combination of glucocorticoids and methotrexate significantly improves the clinical symptoms of the disease.
嗜酸性筋膜炎是一种罕见的结缔组织疾病，常因误诊或漏诊而延误治疗。在疾病晚期，严重的皮肤硬化可导致关节挛缩和肌腱挛缩，严重影响生活质量。因此，明确诊断并在疾病早期进行干预非常重要。
我们报告一例52岁的中国患者，其四肢尤其是前臂和小腿出现明显的对称性肿胀，皮下组织硬化，关节活动受限，初诊时血清学指标显示血清嗜酸性粒细胞显著升高。经软组织磁共振成像和皮下组织活检进一步明确诊断并治疗后，患者对治疗反应良好，皮肤硬化和生活质量明显改善。
增强磁共振成像和全层活检在嗜酸性筋膜炎的早期诊断中起关键作用，而糖皮质激素和甲氨蝶呤联合早期治疗可显著改善该病的临床症状。
